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 $691.83 Median $691.83 Typical High $3,890.45 | Professional | None | $691.83 | $691.83 | $3,890.45 |
BCBS Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $2,137.96 | Facility | None | $933.25 | $1,445.44 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $2,344.23 | Facility | None | $776.25 | $1,905.46 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $891.25 | Professional | None | $524.81 | $724.44 | $891.25 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $1,659.59 Typical High $8,709.64 | Facility | None | $870.96 | $1,659.59 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $4,786.30 | Professional | None | $549.54 | $676.08 | $4,786.30 |
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 $524.81 Median $645.65 Typical High $831.76 | Professional | None | $524.81 | $645.65 | $831.76 |
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 $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $489.78 |
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· 24th of 51
$933
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.