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 $1,479.11 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,479.11 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $1,023.29 | Facility | None | $501.19 | $512.86 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,659.59 | $1,995.26 |
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 $1,023.29 Median $1,122.02 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,122.02 | $2,089.30 |
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 $524.81 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $524.81 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $208.93 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $794.33 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $158.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $104.71 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $741.31 | $954.99 | $954.99 |
Where Arkansas sits
The same service costs 5.6 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· 32nd of 51
$1,349
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.