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 $512.86 Median $1,380.38 Typical High $2,454.71 | Facility | None | $512.86 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $512.86 | Professional | None | $416.87 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Facility | None | $501.19 | $501.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $758.58 | Professional | None | $309.03 | $630.96 | $758.58 |
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 $380.19 Median $426.58 Typical High $831.76 | Professional | None | $380.19 | $426.58 | $831.76 |
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 $199.53 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $79.43 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $302.00 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $60.26 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $39.81 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $281.84 | $363.08 | $363.08 |
Where Arkansas sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$513
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.