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 $1,548.82 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,548.82 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,548.82 | $1,548.82 |
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 $1,174.90 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,905.46 | $2,290.87 |
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 $1,148.15 Median $1,288.25 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,288.25 | $2,454.71 |
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 $602.56 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $602.56 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $912.01 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $181.97 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $120.23 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $1,096.48 | $1,096.48 |
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· 30th of 51
$1,549
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.