How much rates vary
Facilitymedian $1,096 · 10th to 90th $170 to $3,020Professionalmedian $562 · 10th to 90th $427 to $3,467
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 $630.96 Median $2,454.71 Typical High $7,585.78 | Facility | None | $630.96 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | None | $478.63 | $478.63 | $524.81 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $446.68 Median $1,698.24 Typical High $2,951.21 | Facility | None | $446.68 | $1,698.24 | $2,951.21 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $676.08 | Professional | None | $446.68 | $588.84 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $169.82 Typical High $467.74 | Facility | None | $138.04 | $169.82 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $630.96 | Professional | None | $478.63 | $575.44 | $630.96 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $630.96 Typical High $2,187.76 | Facility | None | $112.20 | $630.96 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $3,467.37 Typical High $3,801.89 | Professional | None | $436.52 | $3,467.37 | $3,801.89 |
United Setting Facility Modifier None Typical Low $89.13 Median $602.56 Typical High $1,380.38 | Facility | None | $89.13 | $602.56 | $1,380.38 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $691.83 | Professional | None | $380.19 | $478.63 | $691.83 |
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 $239.88 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $363.08 |
Where Oklahoma sits
The same service costs 4.7 times more in New York than in Florida. 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
NY $3,038FL $649
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.