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 $4,168.69 Typical High $18,620.87 | Facility | None | $1,288.25 | $4,168.69 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,715.35 | $4,168.69 | $4,168.69 |
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 $4,677.35 Typical High $5,248.07 | Professional | None | $3,715.35 | $4,677.35 | $5,248.07 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $4,168.69 Typical High $6,025.60 | Facility | None | $398.11 | $4,168.69 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $3,467.37 Median $4,466.84 Typical High $28,840.32 | Professional | None | $3,467.37 | $4,466.84 | $28,840.32 |
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 $3,311.31 Median $4,073.80 Typical High $6,025.60 | Professional | None | $3,311.31 | $4,073.80 | $6,025.60 |
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 $1,862.09 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,862.09 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $741.31 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,754.23 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $549.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,951.21 | $2,951.21 |
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· 29th of 51
$4,365
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.