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 $1,445.44 Median $4,466.84 Typical High $13,182.57 | Facility | None | $1,445.44 | $4,466.84 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $5,888.44 | Facility | None | $630.96 | $5,011.87 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $5,128.61 | Professional | None | $3,630.78 | $4,466.84 | $5,128.61 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $4,466.84 Typical High $9,332.54 | Facility | None | $1,288.25 | $4,466.84 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $3,311.31 Median $4,365.16 Typical High $27,542.29 | Professional | None | $3,311.31 | $4,365.16 | $27,542.29 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $5,754.40 Typical High $11,220.18 | Facility | None | $1,621.81 | $5,754.40 | $11,220.18 |
United Setting Professional Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $5,623.41 | Professional | None | $3,162.28 | $3,981.07 | $5,623.41 |
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,818.38 | $2,818.38 |
Where Oklahoma sits
The same service costs 20.4 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· 32nd of 51
$4,467
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.