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 $4,897.79 Typical High $14,125.38 | Facility | None | $1,348.96 | $4,897.79 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,890.45 | Professional | None | $1,258.93 | $1,584.89 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,311.31 Typical High $3,801.89 | Facility | None | $870.96 | $3,311.31 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,584.89 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $9,332.54 | Facility | None | $1,479.11 | $1,862.09 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $8,709.64 Typical High $11,220.18 | Professional | None | $1,348.96 | $8,709.64 | $11,220.18 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $5,754.40 Typical High $10,964.78 | Facility | None | $1,621.81 | $5,754.40 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,412.54 | $2,344.23 |
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 $630.96 Median $630.96 Typical High $794.33 | Professional | 52 · Reduced service | $630.96 | $630.96 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $316.23 | Professional | 53 · Discontinued | $251.19 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $239.88 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $158.49 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,122.02 |
Where Oklahoma sits
The same service costs 5.2 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· 23rd of 51
$1,820
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.