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 $1,047.13 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,047.13 | $4,466.84 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $776.25 | Professional | None | $616.60 | $616.60 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $2,187.76 | Facility | None | $630.96 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $794.33 | Professional | None | $575.44 | $707.95 | $794.33 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,202.26 Typical High $6,165.95 | Facility | None | $758.58 | $1,202.26 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $4,365.16 | Professional | None | $501.19 | $660.69 | $4,365.16 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,309.57 | Facility | None | $933.25 | $2,951.21 | $6,309.57 |
United Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $870.96 | Professional | None | $489.78 | $588.84 | $870.96 |
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 $302.00 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Where Oklahoma sits
The same service costs 8.1 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
$708
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.