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 $758.58 Median $2,570.40 Typical High $7,585.78 | Facility | None | $758.58 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $562.34 | Professional | None | $446.68 | $478.63 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,621.81 Typical High $1,862.09 | Facility | None | $407.38 | $1,621.81 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $575.44 | Professional | None | $416.87 | $501.19 | $575.44 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $660.69 Typical High $4,365.16 | Facility | None | $478.63 | $660.69 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $3,388.44 | Professional | None | $398.11 | $512.86 | $3,388.44 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $4,265.80 | Facility | None | $467.74 | $2,041.74 | $4,265.80 |
United Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $676.08 | Professional | None | $371.54 | $457.09 | $676.08 |
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 $218.78 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $218.78 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $87.10 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $338.84 | $346.74 |
Where Oklahoma sits
The same service costs 6.2 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· 31st of 51
$501
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.