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 $3,890.45 Typical High $18,620.87 | Facility | None | $1,000.00 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $776.25 | Professional | None | $645.65 | $724.44 | $776.25 |
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 $645.65 Median $812.83 Typical High $870.96 | Professional | None | $645.65 | $812.83 | $870.96 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $851.14 Typical High $5,888.44 | Facility | None | $398.11 | $851.14 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $4,897.79 | Professional | None | $575.44 | $758.58 | $4,897.79 |
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 $549.54 Median $691.83 Typical High $1,023.29 | Professional | None | $549.54 | $691.83 | $1,023.29 |
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 $323.59 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $323.59 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $489.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $501.19 |
Where Oklahoma sits
The same service costs 5.4 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· 27th of 51
$794
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.