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 $933.25 Median $1,819.70 Typical High $3,019.95 | Facility | None | $933.25 | $1,819.70 | $3,019.95 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $1,148.15 | Professional | None | $912.01 | $933.25 | $1,148.15 |
BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $9,332.54 Typical High $12,589.25 | Facility | None | $4,570.88 | $9,332.54 | $12,589.25 |
BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Professional | None | $812.83 | $812.83 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,677.35 Typical High $5,495.41 | Facility | None | $588.84 | $4,677.35 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,288.25 Typical High $1,412.54 | Professional | None | $602.56 | $1,288.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $9,120.11 | Facility | None | $1,698.24 | $2,570.40 | $9,120.11 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,548.82 | Professional | None | $741.31 | $891.25 | $1,548.82 |
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 $457.09 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $691.83 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $645.65 | $660.69 | $660.69 |
Where Arkansas sits
The same service costs 11.0 times more in Oklahoma than in Utah. 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.
Arkansas· 7th of 51
$1,950
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.