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 $1,698.24 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,698.24 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,698.24 | $1,698.24 |
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 $1,258.93 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,258.93 | $2,089.30 | $2,511.89 |
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 $1,258.93 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,380.38 | $2,630.27 |
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 $645.65 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $645.65 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $977.24 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $131.83 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $912.01 | $1,174.90 | $1,174.90 |
Where Arkansas sits
The same service costs 5.2 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
$1,698
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.