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 $1,258.93 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,258.93 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,258.93 | $1,288.25 |
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 $1,148.15 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,380.38 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,584.89 Typical High $5,888.44 | Facility | None | $398.11 | $1,584.89 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $8,317.64 | Professional | None | $1,023.29 | $1,348.96 | $8,317.64 |
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 $977.24 Median $1,230.27 Typical High $1,819.70 | Professional | None | $977.24 | $1,230.27 | $1,819.70 |
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 $549.54 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $870.96 |
Where Oklahoma sits
The same service costs 5.6 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
$1,380
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.