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 $1,258.93 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,258.93 | $1,412.54 | $1,445.44 |
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 $1,288.25 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,584.89 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,819.70 Typical High $5,888.44 | Facility | None | $398.11 | $1,819.70 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $9,549.93 | Professional | None | $1,174.90 | $1,513.56 | $9,549.93 |
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 $1,096.48 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,380.38 | $2,041.74 |
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 $630.96 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $630.96 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $125.89 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $1,000.00 | $1,000.00 |
Where Oklahoma sits
The same service costs 21.4 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· 28th of 51
$1,549
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.