How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,071.52 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,819.70 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Facility | None | $501.19 | $501.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,380.38 | $2,238.72 | $2,691.53 |
United Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,995.26 | Facility | None | $281.84 | $457.09 | $1,995.26 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,513.56 | $2,818.38 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $707.95 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $141.25 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $1,288.25 | $1,288.25 |
Where Arkansas sits
The same service costs 20.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Arkansas· 27th of 51
$1,820
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.