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 $1,380.38 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,380.38 | $1,380.38 |
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 $933.25 Median $1,698.24 Typical High $2,041.74 | Professional | None | $933.25 | $1,698.24 | $2,041.74 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $1,995.26 | Facility | None | $407.38 | $588.84 | $1,995.26 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,122.02 | $2,137.96 |
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 $537.03 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $537.03 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $213.80 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $162.18 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $758.58 | $977.24 | $977.24 |
Where Arkansas sits
The same service costs 5.5 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· 28th of 51
$1,380
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.