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 $1,258.93 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,258.93 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,258.93 | $1,258.93 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $851.14 Typical High $12,882.50 | Facility | None | $489.78 | $851.14 | $12,882.50 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,698.24 | Facility | None | $1,258.93 | $1,412.54 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,380.38 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,348.96 | $2,089.30 | $3,388.44 |
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 $630.96 Median $630.96 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $131.83 |
Where South Carolina sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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.
South Carolina· 45th of 51
$1,318
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.