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 $2,238.72 Median $5,495.41 Typical High $12,589.25 | Facility | None | $2,238.72 | $5,495.41 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $776.25 | Professional | None | $676.08 | $691.83 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,511.89 Typical High $3,019.95 | Facility | None | $575.44 | $2,511.89 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $8,317.64 | Facility | None | $630.96 | $2,137.96 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $3,715.35 | Professional | None | $575.44 | $794.33 | $3,715.35 |
United Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $6,760.83 | Facility | None | $691.83 | $2,187.76 | $6,760.83 |
United Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,096.48 | Professional | None | $549.54 | $794.33 | $1,096.48 |
5 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 $316.23 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $316.23 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $77.62 |
Where Kansas sits
The same service costs 10.2 times more in Texas than in New York. 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.
Kansas· 32nd 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.