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 $165.96 Median $3,890.45 Typical High $18,620.87 | Facility | None | $165.96 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $165.96 | Professional | None | $112.20 | $162.18 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $467.74 | Facility | None | $117.49 | $141.25 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $204.17 | Professional | None | $114.82 | $162.18 | $204.17 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $208.93 Typical High $3,467.37 | Facility | None | $134.90 | $208.93 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $776.25 Typical High $1,122.02 | Professional | None | $138.04 | $776.25 | $1,122.02 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $3,890.45 | Facility | None | $467.74 | $2,041.74 | $3,890.45 |
United Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $223.87 | Professional | None | $89.13 | $134.90 | $223.87 |
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 $56.23 Median $56.23 Typical High $83.18 | Professional | 52 · Reduced service | $56.23 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $22.39 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $85.11 Typical High $125.89 | Professional | 54 · Surgery only | $83.18 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.98 Typical High $25.12 | Professional | 55 · Aftercare only | $16.60 | $16.98 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $79.43 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $77.62 | $79.43 | $117.49 |
Where Oklahoma sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 17th of 51
$191
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.