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 $4,466.84 Typical High $13,182.57 | Facility | None | $1,288.25 | $4,466.84 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $1,071.52 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,318.26 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $14,125.38 | Facility | None | $1,148.15 | $2,290.87 | $14,125.38 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $8,128.31 | Professional | None | $954.99 | $1,380.38 | $8,128.31 |
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 $891.25 Median $1,174.90 Typical High $1,905.46 | Professional | None | $891.25 | $1,174.90 | $1,905.46 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Where Oklahoma sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 38th of 51
$1,349
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.