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 $4,786.30 Typical High $18,620.87 | Facility | None | $1,288.25 | $4,786.30 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,265.80 | $4,786.30 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $1,258.93 | Facility | None | $549.54 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $5,370.32 Typical High $6,165.95 | Professional | None | $3,715.35 | $5,370.32 | $6,165.95 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $4,168.69 Typical High $6,309.57 | Facility | None | $398.11 | $4,168.69 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $31,622.78 | Professional | None | $3,715.35 | $5,248.07 | $31,622.78 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,025.60 | Facility | None | $426.58 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $3,801.89 Median $4,786.30 Typical High $6,918.31 | Professional | None | $3,801.89 | $4,786.30 | $6,918.31 |
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 $2,137.96 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,137.96 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,630.78 Typical High $3,630.78 | Professional | 54 · Surgery only | $3,162.28 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $630.96 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $426.58 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $3,388.44 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,951.21 | $3,388.44 | $3,388.44 |
Where Oklahoma sits
The same service costs 21.9 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· 32nd of 51
$5,012
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.