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 $436.52 Median $1,288.25 Typical High $2,454.71 | Facility | None | $436.52 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | None | $436.52 | $436.52 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $758.58 | Facility | None | $501.19 | $501.19 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $602.56 Typical High $676.08 | Professional | None | $309.03 | $602.56 | $676.08 |
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 $354.81 Median $436.52 Typical High $794.33 | Professional | None | $354.81 | $436.52 | $794.33 |
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 $218.78 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $218.78 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | 53 · Discontinued | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 54 · Surgery only | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $323.59 |
Where Arkansas sits
The same service costs 6.0 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· 38th of 51
$501
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.