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 $1,000.00 Median $3,162.28 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,162.28 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $3,162.28 | Professional | None | $933.25 | $933.25 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,905.46 Typical High $2,187.76 | Facility | None | $512.86 | $1,905.46 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,071.52 | Professional | None | $645.65 | $954.99 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,659.59 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $6,456.54 | Professional | None | $660.69 | $870.96 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,073.80 Typical High $9,120.11 | Facility | None | $1,230.27 | $4,073.80 | $9,120.11 |
United Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,023.29 | Professional | None | $645.65 | $776.25 | $1,023.29 |
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 $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $95.50 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Where Oklahoma sits
The same service costs 8.3 times more in Wyoming 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· 32nd of 51
$977
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.