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 $4,466.84 Typical High $13,182.57 | Facility | None | $1,288.25 | $4,466.84 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,445.44 | Facility | None | $776.25 | $1,202.26 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $758.58 | Professional | None | $478.63 | $645.65 | $758.58 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $1,148.15 Typical High $6,165.95 | Facility | None | $707.95 | $1,148.15 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $4,265.80 | Professional | None | $478.63 | $588.84 | $4,265.80 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,165.95 | Facility | None | $933.25 | $2,951.21 | $6,165.95 |
United Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $724.44 | Professional | None | $457.09 | $549.54 | $724.44 |
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 $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | 54 · Surgery only | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $436.52 |
Where Oklahoma sits
The same service costs 8.5 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· 35th of 51
$661
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.