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 $1,000.00 Median $3,162.28 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,162.28 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | None | $741.31 | $812.83 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $724.44 Typical High $891.25 | Facility | None | $512.86 | $724.44 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,023.29 | Professional | None | $724.44 | $851.14 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,365.16 | Facility | None | $524.81 | $1,071.52 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $5,623.41 | Professional | None | $691.83 | $891.25 | $5,623.41 |
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 $630.96 Median $776.25 Typical High $1,148.15 | Professional | None | $630.96 | $776.25 | $1,148.15 |
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 $371.54 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $371.54 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $575.44 |
Where Oklahoma sits
The same service costs 4.7 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· 30th of 51
$851
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.