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 $1,445.44 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,445.44 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,445.44 | $1,445.44 |
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 $812.83 Median $1,513.56 Typical High $2,454.71 | Professional | None | $812.83 | $1,513.56 | $2,454.71 |
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 $1,000.00 Median $1,148.15 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,148.15 | $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 $707.95 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $707.95 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,023.29 |
Where Arkansas sits
The same service costs 5.6 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· 44th of 51
$1,148
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.