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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,621.81 | Professional | None | $812.83 | $1,258.93 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $2,691.53 | Facility | None | $575.44 | $2,137.96 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $2,398.83 Typical High $5,888.44 | Facility | None | $977.24 | $2,398.83 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,584.89 | $2,041.74 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,370.32 | Facility | None | $1,000.00 | $2,818.38 | $5,370.32 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,445.44 | $2,137.96 | $3,548.13 |
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 $407.38 Median $630.96 Typical High $812.83 | Professional | 52 · Reduced service | $407.38 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $257.04 Typical High $323.59 | Professional | 53 · Discontinued | $162.18 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $954.99 Typical High $1,202.26 | Professional | 54 · Surgery only | $616.60 | $954.99 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $190.55 Typical High $239.88 | Professional | 55 · Aftercare only | $123.03 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $125.89 Typical High $162.18 | Professional | 56 · Pre-op care only | $81.28 | $125.89 | $162.18 |
Where Missouri sits
The same service costs 109.6 times more in Alaska than in Kentucky. 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.
Missouri· 16th of 51
$2,042
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.