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 $1,380.38 Median $5,754.40 Typical High $16,982.44 | Facility | None | $1,380.38 | $5,754.40 | $16,982.44 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $933.25 | Professional | None | $741.31 | $831.76 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $2,344.23 | Facility | None | $549.54 | $891.25 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,071.52 | Professional | None | $794.33 | $933.25 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $7,244.36 | Facility | None | $457.09 | $1,071.52 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $5,623.41 | Professional | None | $691.83 | $912.01 | $5,623.41 |
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 $645.65 Median $812.83 Typical High $1,202.26 | Professional | None | $645.65 | $812.83 | $1,202.26 |
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 $371.54 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $588.84 |
Where Oklahoma sits
The same service costs 5.9 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· 31st of 51
$933
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.