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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,168.69 Typical High $4,897.79 | Facility | None | $630.96 | $4,168.69 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,778.28 | $1,905.46 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $9,332.54 | Facility | None | $1,548.82 | $2,238.72 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $14,454.40 | Professional | None | $1,445.44 | $2,041.74 | $14,454.40 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $5,754.40 Typical High $10,964.78 | Facility | None | $1,621.81 | $5,754.40 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,659.59 | $2,398.83 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
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· 34th of 51
$1,905
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.