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 $2,570.40 | Facility | None | $1,071.52 | $1,862.09 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Facility | None | $501.19 | $501.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $3,890.45 Typical High $4,677.35 | Professional | None | $1,513.56 | $3,890.45 | $4,677.35 |
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 $1,778.28 Median $2,238.72 Typical High $4,365.16 | Professional | None | $1,778.28 | $2,238.72 | $4,365.16 |
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 $1,174.90 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,174.90 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,778.28 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $234.42 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,778.28 | $1,778.28 |
Where Arkansas sits
The same service costs 8.1 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· 48th of 51
$1,862
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.