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 $1,445.44 Median $4,466.84 Typical High $13,182.57 | Facility | None | $1,445.44 | $4,466.84 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,981.07 Typical High $4,677.35 | Facility | None | $776.25 | $3,981.07 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,388.44 | $3,801.89 |
Medica Setting Facility Modifier None Typical Low $1,949.84 Median $3,311.31 Typical High $14,454.40 | Facility | None | $1,949.84 | $3,311.31 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $2,398.83 Median $3,162.28 Typical High $20,892.96 | Professional | None | $2,398.83 | $3,162.28 | $20,892.96 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $7,762.47 Typical High $15,135.61 | Facility | None | $1,905.46 | $7,762.47 | $15,135.61 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $4,168.69 | Professional | None | $2,290.87 | $2,818.38 | $4,168.69 |
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,089.30 |
Where Oklahoma sits
The same service costs 19.5 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
$3,311
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.