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 $3,890.45 Typical High $18,620.87 | Facility | None | $1,288.25 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $1,819.70 | Professional | None | $1,584.89 | $1,778.28 | $1,819.70 |
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 $1,621.81 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,995.26 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $2,290.87 Typical High $5,888.44 | Facility | None | $398.11 | $2,290.87 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $12,022.64 | Professional | None | $1,479.11 | $1,905.46 | $12,022.64 |
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 $1,380.38 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,737.80 | $2,570.40 |
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 $794.33 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $794.33 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,202.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,258.93 | $1,258.93 |
Where Oklahoma sits
The same service costs 20.4 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· 29th of 51
$1,950
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.