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 $3,388.44 Median $3,801.89 Typical High $3,890.45 | Professional | None | $3,388.44 | $3,801.89 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $3,981.07 Typical High $5,888.44 | Facility | None | $398.11 | $3,981.07 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $3,162.28 Median $4,168.69 Typical High $25,703.96 | Professional | None | $3,162.28 | $4,168.69 | $25,703.96 |
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 $3,019.95 Median $3,715.35 Typical High $5,495.41 | Professional | None | $3,019.95 | $3,715.35 | $5,495.41 |
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 $1,698.24 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,698.24 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $676.08 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,511.89 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $501.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,691.53 | $2,691.53 |
Where Oklahoma sits
The same service costs 27.5 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· 38th of 51
$3,802
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.