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 $389.05 Median $3,890.45 Typical High $18,620.87 | Facility | None | $389.05 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $389.05 | Professional | None | $208.93 | $380.19 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $125.89 | Facility | None | $50.12 | $75.86 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $416.87 | Professional | None | $239.88 | $380.19 | $416.87 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $457.09 Typical High $1,174.90 | Facility | None | $95.50 | $457.09 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $3,890.45 Typical High $3,981.07 | Professional | None | $380.19 | $3,890.45 | $3,981.07 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $512.86 | Professional | None | $199.53 | $338.84 | $512.86 |
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 $104.71 Median $104.71 Typical High $190.55 | Professional | 52 · Reduced service | $104.71 | $104.71 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $77.62 | Professional | 53 · Discontinued | $41.69 | $42.66 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $158.49 Typical High $288.40 | Professional | 54 · Surgery only | $154.88 | $158.49 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $269.15 |
Where Oklahoma sits
The same service costs 4.6 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.
Oklahoma· 15th of 51
$417
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.