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 $1,819.70 Median $3,715.35 Typical High $7,943.28 | Facility | None | $1,819.70 | $3,715.35 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $436.52 | Professional | None | $295.12 | $309.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $1,698.24 | Facility | None | $575.44 | $1,412.54 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $1,000.00 Typical High $3,890.45 | Facility | None | $457.09 | $1,000.00 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $2,570.40 | Professional | None | $478.63 | $676.08 | $2,570.40 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,047.13 Typical High $3,311.31 | Facility | None | $501.19 | $1,047.13 | $3,311.31 |
United Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $794.33 | Professional | None | $457.09 | $676.08 | $794.33 |
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 $147.91 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | 53 · Discontinued | $60.26 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $223.87 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $33.11 |
Where Kansas sits
The same service costs 8.1 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· 34th of 51
$692
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.