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 $1,288.25 Median $4,466.84 Typical High $13,182.57 | Facility | None | $1,288.25 | $4,466.84 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,000.00 | Professional | None | $812.83 | $870.96 | $1,000.00 |
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 $851.14 Median $933.25 Typical High $1,122.02 | Professional | None | $851.14 | $933.25 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $10,715.19 | Facility | None | $1,071.52 | $2,238.72 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $7,079.46 | Professional | None | $776.25 | $1,000.00 | $7,079.46 |
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 $676.08 Median $851.14 Typical High $1,258.93 | Professional | None | $676.08 | $851.14 | $1,258.93 |
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 $398.11 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $162.18 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $630.96 |
Where Oklahoma sits
The same service costs 6.5 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· 34th of 51
$933
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.