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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $16,218.10 Typical High $25,118.86 | Facility | None | $9,772.37 | $16,218.10 | $25,118.86 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $5,754.40 | Facility | None | $891.25 | $1,445.44 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,290.87 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $2,570.40 Typical High $5,888.44 | Facility | None | $457.09 | $2,570.40 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $13,182.57 | Professional | None | $1,621.81 | $2,137.96 | $13,182.57 |
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 $1,548.82 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,548.82 | $1,949.84 | $2,511.89 |
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 $831.76 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,174.90 |
Where Oklahoma sits
The same service costs 5.9 times more in Alaska 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.
Oklahoma· 26th of 51
$2,291
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.