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 $1,621.81 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,621.81 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,621.81 | $1,621.81 |
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 $1,202.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,995.26 | $2,398.83 |
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 $1,174.90 Median $1,318.26 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,318.26 | $2,511.89 |
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 $630.96 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $630.96 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $933.25 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $186.21 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $125.89 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $870.96 | $1,122.02 | $1,122.02 |
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· 28th of 51
$1,622
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.