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 $1,445.44 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,445.44 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,890.45 | Professional | None | $1,513.56 | $1,513.56 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,905.46 Typical High $2,344.23 | Facility | None | $870.96 | $1,905.46 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,513.56 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $8,709.64 | Facility | None | $1,288.25 | $1,737.80 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $11,220.18 | Professional | None | $1,096.48 | $1,412.54 | $11,220.18 |
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 $1,071.52 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,288.25 | $1,698.24 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,071.52 |
Where Oklahoma sits
The same service costs 7.4 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· 35th of 51
$1,514
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.