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 $467.74 Median $3,890.45 Typical High $18,620.87 | Facility | None | $467.74 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $467.74 | Professional | None | $346.74 | $457.09 | $467.74 |
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 $363.08 Median $467.74 Typical High $588.84 | Professional | None | $363.08 | $467.74 | $588.84 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $524.81 Typical High $1,513.56 | Facility | None | $95.50 | $524.81 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $2,691.53 Typical High $3,548.13 | Professional | None | $426.58 | $2,691.53 | $3,548.13 |
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 $309.03 Median $416.87 Typical High $588.84 | Professional | None | $309.03 | $416.87 | $588.84 |
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 $173.78 Median $173.78 Typical High $234.42 | Professional | 52 · Reduced service | $173.78 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $70.79 Typical High $93.33 | Professional | 53 · Discontinued | $69.18 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $354.81 | Professional | 54 · Surgery only | $263.03 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $70.79 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $35.48 Typical High $46.77 | Professional | 56 · Pre-op care only | $34.67 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $331.13 |
Where Oklahoma sits
The same service costs 4.7 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· 19th of 51
$513
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.