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 $4,570.88 | Facility | None | $1,071.52 | $1,862.09 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $4,570.88 Typical High $4,570.88 | Professional | None | $3,548.13 | $4,570.88 | $4,570.88 |
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 $3,311.31 Median $5,370.32 Typical High $6,760.83 | Professional | None | $3,311.31 | $5,370.32 | $6,760.83 |
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 $3,311.31 Median $3,715.35 Typical High $7,079.46 | Professional | None | $3,311.31 | $3,715.35 | $7,079.46 |
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 $1,778.28 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,778.28 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $707.95 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $3,467.37 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,630.27 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $524.81 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $354.81 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $3,235.94 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,454.71 | $3,235.94 | $3,235.94 |
Where Arkansas sits
The same service costs 21.9 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· 26th of 51
$4,571
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.