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 $316.23 Median $3,890.45 Typical High $18,620.87 | Facility | None | $316.23 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $316.23 | Professional | None | $194.98 | $269.15 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $169.82 Typical High $194.98 | Facility | None | $66.07 | $169.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $389.05 | Professional | None | $223.87 | $257.04 | $389.05 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $363.08 Typical High $1,174.90 | Facility | None | $95.50 | $363.08 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $1,380.38 Typical High $2,398.83 | Professional | None | $257.04 | $1,380.38 | $2,398.83 |
United Setting Facility Modifier None Typical Low $89.13 Median $602.56 Typical High $1,380.38 | Facility | None | $89.13 | $602.56 | $1,380.38 |
United Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $363.08 | Professional | None | $162.18 | $245.47 | $363.08 |
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 $95.50 Median $95.50 Typical High $158.49 | Professional | 52 · Reduced service | $95.50 | $95.50 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $63.10 | Professional | 53 · Discontinued | $38.90 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $239.88 | Professional | 54 · Surgery only | $144.54 | $144.54 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $47.86 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $31.62 |
Where Oklahoma sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 24th of 51
$309
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.