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 $912.01 Median $1,698.24 Typical High $2,511.89 | Facility | None | $912.01 | $1,698.24 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | None | $794.33 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $1,122.02 | Facility | None | $562.34 | $724.44 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $1,548.82 | Professional | None | $812.83 | $1,230.27 | $1,548.82 |
United Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,995.26 | Facility | None | $281.84 | $457.09 | $1,995.26 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,548.82 | Professional | None | $676.08 | $1,000.00 | $1,548.82 |
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 $398.11 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $398.11 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $588.84 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $79.43 | $91.20 | $91.20 |
Where Arkansas sits
The same service costs 3.8 times more in Wisconsin than in New York. 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.
Arkansas· 38th of 51
$912
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.