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 $1,318.26 Median $1,479.11 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,479.11 | $1,513.56 |
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 $1,348.96 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,621.81 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,905.46 Typical High $5,888.44 | Facility | None | $398.11 | $1,905.46 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $9,772.37 | Professional | None | $1,230.27 | $1,584.89 | $9,772.37 |
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 $1,148.15 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,445.44 | $2,137.96 |
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 $660.69 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $194.98 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $1,023.29 | $1,023.29 |
Where Oklahoma sits
The same service costs 5.2 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· 30th of 51
$1,622
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.