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 $1,047.13 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,047.13 | $4,466.84 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | None | $831.76 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $575.44 Typical High $776.25 | Facility | None | $501.19 | $575.44 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,258.93 | Professional | None | $794.33 | $1,174.90 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $977.24 Typical High $4,168.69 | Facility | None | $331.13 | $977.24 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $6,760.83 | Professional | None | $794.33 | $1,047.13 | $6,760.83 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,258.93 Typical High $2,454.71 | Facility | None | $269.15 | $1,258.93 | $2,454.71 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,288.25 | Professional | None | $741.31 | $891.25 | $1,288.25 |
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 $416.87 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $416.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $83.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Oklahoma sits
The same service costs 22.4 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· 27th of 51
$1,096
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.