How much rates vary
Facilitymedian $5,623 · 10th to 90th $427 to $20,893Professionalmedian $355 · 10th to 90th $263 to $8,318
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 $758.58 Median $2,570.40 Typical High $7,585.78 | Facility | None | $758.58 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $15,135.61 Typical High $21,379.62 | Facility | None | $407.38 | $15,135.61 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $426.58 | Professional | None | $316.23 | $389.05 | $426.58 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $3,890.45 Typical High $20,892.96 | Facility | None | $416.87 | $3,890.45 | $20,892.96 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $8,317.64 | Professional | None | $269.15 | $354.81 | $8,317.64 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $12,022.64 Typical High $22,387.21 | Facility | None | $3,235.94 | $12,022.64 | $22,387.21 |
United Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $416.87 | Professional | None | $257.04 | $323.59 | $416.87 |
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 $138.04 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $208.93 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $194.98 | $199.53 | $199.53 |
Where Oklahoma sits
The same service costs 29.1 times more in Alabama than in Montana. 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.
Physician feeFacility fee
AL $30,626MT $1,051
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.