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 $1,288.25 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 $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $10,232.93 Typical High $12,022.64 | Facility | None | $630.96 | $10,232.93 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,344.23 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $2,041.74 Median $3,890.45 Typical High $20,417.38 | Facility | None | $2,041.74 | $3,890.45 | $20,417.38 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $14,125.38 | Professional | None | $1,698.24 | $2,238.72 | $14,125.38 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $10,964.78 Typical High $21,379.62 | Facility | None | $3,235.94 | $10,964.78 | $21,379.62 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,995.26 | $2,884.03 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Where Oklahoma sits
The same service costs 16.2 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· 33rd of 51
$2,344
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.