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 $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $10,964.78 Typical High $17,378.01 | Facility | None | $6,606.93 | $10,964.78 | $17,378.01 |
BCBS Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $977.24 | Professional | None | $707.95 | $954.99 | $977.24 |
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 $794.33 Median $870.96 Typical High $1,023.29 | Professional | None | $794.33 | $870.96 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $1,148.15 Typical High $6,165.95 | Facility | None | $870.96 | $1,148.15 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $5,495.41 | Professional | None | $645.65 | $851.14 | $5,495.41 |
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 $602.56 Median $724.44 Typical High $1,000.00 | Professional | None | $602.56 | $724.44 | $1,000.00 |
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 $389.05 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $537.03 |
Where Oklahoma sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 27th of 51
$955
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.