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 $1,348.96 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,348.96 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $5,623.41 Typical High $6,606.93 | Facility | None | $870.96 | $5,623.41 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,230.27 | $1,513.56 |
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 $912.01 Median $1,174.90 Typical High $7,585.78 | Professional | None | $912.01 | $1,174.90 | $7,585.78 |
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 $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | None | $870.96 | $1,071.52 | $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 $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Oklahoma sits
The same service costs 7.9 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· 34th of 51
$1,230
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.