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 $1,380.38 Median $5,754.40 Typical High $16,982.44 | Facility | None | $1,380.38 | $5,754.40 | $16,982.44 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $4,073.80 | Facility | None | $1,230.27 | $3,311.31 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,000.00 | Professional | None | $707.95 | $870.96 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $1,202.26 Typical High $8,709.64 | Facility | None | $870.96 | $1,202.26 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $7,585.78 | Professional | None | $645.65 | $870.96 | $7,585.78 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,096.48 | Professional | None | $645.65 | $776.25 | $1,096.48 |
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 $389.05 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
Where Oklahoma sits
The same service costs 17.4 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· 30th of 51
$871
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.