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 $1,148.15 Median $4,365.16 Typical High $13,182.57 | Facility | None | $1,148.15 | $4,365.16 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $912.01 | Professional | None | $707.95 | $831.76 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,311.31 Typical High $3,801.89 | Facility | None | $776.25 | $3,311.31 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,023.29 | Professional | None | $707.95 | $870.96 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $1,174.90 Typical High $6,165.95 | Facility | None | $891.25 | $1,174.90 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $5,011.87 Typical High $6,456.54 | Professional | None | $776.25 | $5,011.87 | $6,456.54 |
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 $588.84 Median $758.58 Typical High $1,122.02 | Professional | None | $588.84 | $758.58 | $1,122.02 |
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 $354.81 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $354.81 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $562.34 | $645.65 |
Where Oklahoma sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 28th 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.