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 $724.44 Median $2,511.89 Typical High $8,317.64 | Facility | None | $724.44 | $2,511.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $21.88 Typical High $891.25 | Professional | None | $19.05 | $21.88 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $416.87 | Facility | None | $346.74 | $346.74 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,454.71 Typical High $8,317.64 | Facility | None | $724.44 | $2,454.71 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $19.05 Median $32.36 Typical High $1,318.26 | Professional | None | $19.05 | $32.36 | $1,318.26 |
United Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $1,230.27 | Facility | None | $70.79 | $141.25 | $1,230.27 |
United Setting Professional Modifier None Typical Low $18.62 Median $21.38 Typical High $33.88 | Professional | None | $18.62 | $21.38 | $33.88 |
7 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 $9.33 Median $10.72 Typical High $63.10 | Professional | 52 · Reduced service | $9.33 | $10.72 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.27 Typical High $25.12 | Professional | 53 · Discontinued | $3.72 | $4.27 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $15.85 Typical High $95.50 | Professional | 54 · Surgery only | $14.13 | $15.85 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.24 Typical High $19.05 | Professional | 55 · Aftercare only | $2.82 | $3.24 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.14 Typical High $12.59 | Professional | 56 · Pre-op care only | $1.86 | $2.14 | $12.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $10.72 Typical High $63.10 | Professional | 52 · Reduced service | $9.55 | $10.72 | $63.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $15.85 Typical High $95.50 | Professional | 54 · Surgery only | $14.13 | $15.85 | $95.50 |
Where Pennsylvania sits
The same service costs 14.5 times more in New Hampshire than in New Jersey. 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.
Pennsylvania· 44th of 51
$22.39
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.