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 $1,412.54 Median $1,412.54 Typical High $1,737.80 | Facility | None | $1,412.54 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,412.54 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $1,258.93 | Facility | None | $630.96 | $912.01 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,621.81 | $1,995.26 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $8,709.64 | Facility | None | $1,479.11 | $2,511.89 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $10,000.00 Typical High $12,302.69 | Professional | None | $1,548.82 | $10,000.00 | $12,302.69 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,370.32 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,370.32 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,659.59 | $2,238.72 |
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 $707.95 Median $707.95 Typical High $870.96 | Professional | 52 · Reduced service | $707.95 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $173.78 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,230.27 |
Where Oklahoma sits
The same service costs 5.1 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· 30th of 51
$1,995
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.