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 $2,951.21 | Facility | None | $1,071.52 | $1,862.09 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,951.21 | $2,951.21 |
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 $1,778.28 Median $4,786.30 Typical High $5,370.32 | Professional | None | $1,778.28 | $4,786.30 | $5,370.32 |
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 $2,137.96 Median $2,630.27 Typical High $5,011.87 | Professional | None | $2,137.96 | $2,630.27 | $5,011.87 |
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 $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,445.44 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $588.84 Typical High $602.56 | Professional | 53 · Discontinued | $575.44 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,187.76 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $436.52 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $295.12 Typical High $302.00 | Professional | 56 · Pre-op care only | $288.40 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,089.30 | $2,089.30 |
Where Arkansas sits
The same service costs 10.0 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
$2,291
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.