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 $1,174.90 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,174.90 | $4,466.84 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,174.90 | $1,202.26 | $1,202.26 |
BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $14,791.08 Typical High $23,442.29 | Facility | None | $8,912.51 | $14,791.08 | $23,442.29 |
BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,698.24 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,466.84 Typical High $5,248.07 | Facility | None | $630.96 | $4,466.84 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,621.81 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $10,715.19 | Facility | None | $1,513.56 | $2,238.72 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $9,772.37 | Professional | None | $1,174.90 | $1,513.56 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $5,754.40 Typical High $11,220.18 | Facility | None | $1,621.81 | $5,754.40 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,380.38 | $1,819.70 |
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 $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Where Oklahoma sits
The same service costs 11.0 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· 29th of 51
$1,698
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.