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 $1,513.56 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,513.56 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,023.29 | Facility | None | $501.19 | $501.19 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,862.09 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $5,370.32 | Facility | None | $1,412.54 | $1,995.26 | $5,370.32 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,258.93 | $2,398.83 |
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 $588.84 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $588.84 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $1,071.52 | $1,071.52 |
Where Arkansas sits
The same service costs 26.3 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· 31st of 51
$1,514
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.