How much rates vary
Facilitymedian $1,072 · 10th to 90th $138 to $2,344Professionalmedian $355 · 10th to 90th $263 to $2,089
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 $338.84 Median $3,890.45 Typical High $18,620.87 | Facility | None | $338.84 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | None | $288.40 | $288.40 | $338.84 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $2,290.87 | Facility | None | $912.01 | $1,479.11 | $2,290.87 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $426.58 | Professional | None | $263.03 | $363.08 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $151.36 Typical High $169.82 | Facility | None | $66.07 | $151.36 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $407.38 | Professional | None | $302.00 | $354.81 | $407.38 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $407.38 Typical High $1,318.26 | Facility | None | $95.50 | $407.38 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $2,089.30 Typical High $2,454.71 | Professional | None | $281.84 | $2,089.30 | $2,454.71 |
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 $229.09 Median $295.12 Typical High $416.87 | Professional | None | $229.09 | $295.12 | $416.87 |
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 $144.54 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $234.42 |
Where Oklahoma sits
The same service costs 6.7 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 $2,828FL $419
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.