How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $1,445 · 10th to 90th $1,072 to $2,089
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 $1,445.44 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,445.44 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,445.44 | $1,445.44 |
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 $977.24 Median $1,778.28 Typical High $2,137.96 | Professional | None | $977.24 | $1,778.28 | $2,137.96 |
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 $1,047.13 Median $1,174.90 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,174.90 | $2,238.72 |
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 $562.34 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $562.34 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $169.82 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $1,000.00 | $1,000.00 |
Where Arkansas sits
The same service costs 5.9 times more in Alabama than in Maryland. 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.
Physician feeFacility fee
AL $10,682MD $1,821
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.