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 $933.25 Median $1,862.09 Typical High $3,630.78 | Facility | None | $933.25 | $1,862.09 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | None | $724.44 | $933.25 | $933.25 |
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 $691.83 Median $1,122.02 Typical High $1,380.38 | Professional | None | $691.83 | $1,122.02 | $1,380.38 |
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 $691.83 Median $758.58 Typical High $1,445.44 | Professional | None | $691.83 | $758.58 | $1,445.44 |
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 $363.08 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $144.54 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $72.44 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $501.19 | $645.65 | $645.65 |
Where Arkansas sits
The same service costs 5.9 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· 30th of 51
$933
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.