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 $2,454.71 | Facility | None | $1,071.52 | $1,862.09 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,584.89 | $2,089.30 | $2,089.30 |
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 $1,584.89 Median $2,570.40 Typical High $3,019.95 | Professional | None | $1,584.89 | $2,570.40 | $3,019.95 |
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 $1,548.82 Median $1,737.80 Typical High $3,235.94 | Professional | None | $1,548.82 | $1,737.80 | $3,235.94 |
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 $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $794.33 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $323.59 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $239.88 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $158.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,445.44 | $1,445.44 |
Where Arkansas sits
The same service costs 5.4 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
$2,089
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.