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 $1,071.52 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,071.52 | $4,466.84 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,981.07 Typical High $4,677.35 | Facility | None | $630.96 | $3,981.07 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,202.26 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $8,709.64 | Facility | None | $1,174.90 | $1,698.24 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $7,413.10 | Professional | None | $891.25 | $1,230.27 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,073.80 Typical High $9,120.11 | Facility | None | $1,230.27 | $4,073.80 | $9,120.11 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,548.82 | Professional | None | $851.14 | $1,096.48 | $1,548.82 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
Where Oklahoma sits
The same service costs 8.3 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· 35th of 51
$1,202
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.