How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,380 to $14,454Professionalmedian $1,905 · 10th to 90th $1,413 to $15,849
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 $4,073.80 Typical High $16,218.10 | Facility | None | $1,288.25 | $4,073.80 | $16,218.10 |
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 |
Ambetter Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,949.84 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,413.10 Typical High $8,511.38 | Facility | None | $630.96 | $7,413.10 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,659.59 | $1,949.84 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $14,454.40 | Facility | None | $1,445.44 | $2,290.87 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $15,848.93 | Professional | None | $1,445.44 | $1,862.09 | $15,848.93 |
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 $1,380.38 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,698.24 | $2,454.71 |
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 5.3 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $17,981KY $3,363
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.