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 $1,862.09 Typical High $3,090.30 | Facility | None | $1,071.52 | $1,862.09 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,511.89 | $3,090.30 | $3,090.30 |
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 $1,819.70 Median $5,128.61 Typical High $5,623.41 | Professional | None | $1,819.70 | $5,128.61 | $5,623.41 |
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 $2,238.72 Median $2,691.53 Typical High $5,248.07 | Professional | None | $2,238.72 | $2,691.53 | $5,248.07 |
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 $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,479.11 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $602.56 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,290.87 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,238.72 | $2,290.87 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $457.09 Typical High $467.74 | Professional | 55 · Aftercare only | $446.68 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,137.96 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,137.96 | $2,187.76 |
Where Arkansas sits
The same service costs 17.0 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· 47th of 51
$2,344
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.