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 $1,148.15 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,148.15 | $4,466.84 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,148.15 | $1,148.15 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $2,344.23 | Facility | None | $630.96 | $1,905.46 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,380.38 | Professional | None | $794.33 | $1,174.90 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $8,709.64 | Facility | None | $1,202.26 | $1,659.59 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $7,943.28 | Professional | None | $851.14 | $1,071.52 | $7,943.28 |
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 $831.76 Median $1,000.00 Typical High $1,288.25 | Professional | None | $831.76 | $1,000.00 | $1,288.25 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Oklahoma sits
The same service costs 7.2 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· 34th of 51
$1,202
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.