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 $1,819.70 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,819.70 | $2,511.89 | $2,511.89 |
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 $1,949.84 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,187.76 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $2,137.96 Typical High $6,309.57 | Facility | None | $269.15 | $2,137.96 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $16,982.44 | Professional | None | $2,089.30 | $2,884.03 | $16,982.44 |
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 $1,995.26 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,995.26 | $2,454.71 | $3,801.89 |
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 $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $933.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $371.54 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,412.54 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $281.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $186.21 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,778.28 | $1,778.28 |
Where Oklahoma sits
The same service costs 18.2 times more in Alaska than in New York. 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
$2,512
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.