How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,000 to $6,918Professionalmedian $871 · 10th to 90th $603 to $1,096
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 $794.33 Median $1,380.38 Typical High $2,454.71 | Facility | None | $794.33 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $794.33 | Professional | None | $602.56 | $794.33 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Professional | None | $870.96 | $870.96 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $1,862.09 | Facility | None | $588.84 | $1,513.56 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,148.15 | Professional | None | $616.60 | $1,071.52 | $1,148.15 |
Qualchoice Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $7,413.10 | Facility | None | $1,698.24 | $2,570.40 | $7,413.10 |
United Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,202.26 | Professional | None | $549.54 | $741.31 | $1,202.26 |
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 $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $416.87 | $549.54 | $549.54 |
Where Arkansas sits
The same service costs 7.6 times more in Oklahoma 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.