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 $1,862.09 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,862.09 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,659.59 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,047.13 | Facility | None | $501.19 | $501.19 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $3,162.28 | Professional | None | $1,621.81 | $2,630.27 | $3,162.28 |
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 $1,584.89 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,584.89 | $1,778.28 | $3,388.44 |
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 $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $831.76 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $331.13 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,258.93 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $165.96 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,513.56 | $1,513.56 |
Where Arkansas sits
The same service costs 5.4 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· 29th of 51
$2,138
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.