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 $100.00 Median $3,890.45 Typical High $18,620.87 | Facility | None | $100.00 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $100.00 | Professional | None | $72.44 | $83.18 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $89.13 Typical High $125.89 | Facility | None | $66.07 | $89.13 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $120.23 | Professional | None | $81.28 | $95.50 | $120.23 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $138.04 Typical High $1,174.90 | Facility | None | $77.62 | $138.04 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $512.86 Typical High $758.58 | Professional | None | $81.28 | $512.86 | $758.58 |
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 $57.54 Median $81.28 Typical High $114.82 | Professional | None | $57.54 | $81.28 | $114.82 |
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 $36.31 Median $36.31 Typical High $50.12 | Professional | 52 · Reduced service | $36.31 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $19.95 | Professional | 53 · Discontinued | $14.45 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $75.86 | Professional | 54 · Surgery only | $53.70 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $15.14 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $10.00 |
Where Oklahoma sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 32nd of 51
$100
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.