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 $1,288.25 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,288.25 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $15,135.61 Typical High $17,782.79 | Facility | None | $630.96 | $15,135.61 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $4,466.84 | Professional | None | $3,311.31 | $3,890.45 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $3,090.30 Median $4,365.16 Typical High $20,417.38 | Facility | None | $3,090.30 | $4,365.16 | $20,417.38 |
Medica Setting Professional Modifier None Typical Low $2,884.03 Median $3,801.89 Typical High $26,915.35 | Professional | None | $2,884.03 | $3,801.89 | $26,915.35 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $10,964.78 Typical High $21,877.62 | Facility | None | $3,235.94 | $10,964.78 | $21,877.62 |
United Setting Professional Modifier None Typical Low $2,754.23 Median $3,388.44 Typical High $4,786.30 | Professional | None | $2,754.23 | $3,388.44 | $4,786.30 |
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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,570.40 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,398.83 | $2,398.83 |
Where Oklahoma sits
The same service costs 20.4 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· 32nd of 51
$3,890
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.