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 $831.76 Median $1,288.25 Typical High $2,454.71 | Facility | None | $831.76 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $851.14 | Professional | None | $645.65 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $831.76 | Facility | None | $489.78 | $630.96 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,412.54 Typical High $1,513.56 | Professional | None | $724.44 | $1,412.54 | $1,513.56 |
United Setting Facility Modifier None Typical Low $75.86 Median $128.82 Typical High $707.95 | Facility | None | $75.86 | $128.82 | $707.95 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,318.26 | Professional | None | $575.44 | $776.25 | $1,318.26 |
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 $323.59 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $128.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $489.78 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $97.72 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $64.57 | $85.11 | $85.11 |
Where Arkansas sits
The same service costs 4.7 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· 32nd of 51
$851
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.