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 $1,000.00 Median $3,090.30 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,090.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $1,548.82 Typical High $3,162.28 | Professional | None | $426.58 | $1,548.82 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,318.26 Typical High $1,584.89 | Facility | None | $630.96 | $1,318.26 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $1,047.13 Typical High $2,884.03 | Professional | None | $501.19 | $1,047.13 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $2,570.40 Typical High $8,709.64 | Facility | None | $851.14 | $2,570.40 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $5,495.41 Typical High $20,417.38 | Professional | None | $1,548.82 | $5,495.41 | $20,417.38 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,754.40 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,754.40 | $10,715.19 |
United Setting Professional Modifier None Typical Low $389.05 Median $977.24 Typical High $3,090.30 | Professional | None | $389.05 | $977.24 | $3,090.30 |
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 $213.80 Median $213.80 Typical High $776.25 | Professional | 52 · Reduced service | $213.80 | $213.80 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $316.23 | Professional | 53 · Discontinued | $85.11 | $85.11 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $1,174.90 | Professional | 54 · Surgery only | $316.23 | $323.59 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $234.42 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $158.49 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $302.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $295.12 | $302.00 | $1,096.48 |
Where Oklahoma sits
The same service costs 4.9 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· 9th of 51
$1,995
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.