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 $630.96 Median $1,071.52 Typical High $2,454.71 | Facility | None | $630.96 | $1,071.52 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $707.95 | Professional | None | $537.03 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,122.02 Typical High $2,511.89 | Facility | None | $891.25 | $1,122.02 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,122.02 Typical High $1,174.90 | Professional | None | $588.84 | $1,122.02 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $4,265.80 | Facility | None | $1,096.48 | $1,479.11 | $4,265.80 |
United Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $977.24 | Professional | None | $302.00 | $426.58 | $977.24 |
5 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 $269.15 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $109.65 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $407.38 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $69.18 | $69.18 |
Where Arkansas sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 14th of 51
$794
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.