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 $1,000.00 Median $3,981.07 Typical High $12,589.25 | Facility | None | $1,000.00 | $3,981.07 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $275.42 Typical High $275.42 | Professional | None | $141.25 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $2,137.96 | Facility | None | $630.96 | $1,778.28 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $371.54 | Professional | None | $165.96 | $229.09 | $371.54 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $407.38 Typical High $6,760.83 | Facility | None | $204.17 | $407.38 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $1,174.90 Typical High $2,041.74 | Professional | None | $229.09 | $1,174.90 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,073.80 Typical High $9,120.11 | Facility | None | $1,230.27 | $4,073.80 | $9,120.11 |
United Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $407.38 | Professional | None | $131.83 | $218.78 | $407.38 |
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 $70.79 Median $72.44 Typical High $138.04 | Professional | 52 · Reduced service | $70.79 | $72.44 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.84 Typical High $54.95 | Professional | 53 · Discontinued | $28.18 | $28.84 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $208.93 | Professional | 54 · Surgery only | $107.15 | $107.15 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $41.69 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.45 Typical High $27.54 | Professional | 56 · Pre-op care only | $14.13 | $14.45 | $27.54 |
Where Oklahoma sits
The same service costs 5.8 times more in Alaska than in Hawaii. 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.
Oklahoma· 11th of 51
$398
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.