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 $2,187.76 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,187.76 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,398.83 | Professional | None | $2,187.76 | $2,187.76 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $8,128.31 Typical High $10,232.93 | Facility | None | $489.78 | $8,128.31 | $10,232.93 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $977.24 Typical High $4,897.79 | Facility | None | $316.23 | $977.24 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $10,232.93 | Professional | None | $93.33 | $125.89 | $10,232.93 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $5,248.07 | Facility | None | $407.38 | $1,000.00 | $5,248.07 |
United Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $177.83 | Professional | None | $93.33 | $125.89 | $177.83 |
4 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 $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | 53 · Discontinued | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $354.81 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $239.88 |
Where Kansas sits
The same service costs 30.9 times more in California than in Idaho. 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· 17th of 51
$794
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.