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 $346.74 Median $1,380.38 Typical High $2,454.71 | Facility | None | $346.74 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $346.74 | Professional | None | $295.12 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $1,122.02 | Facility | None | $588.84 | $891.25 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $588.84 | Professional | None | $316.23 | $467.74 | $588.84 |
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 $263.03 Median $380.19 Typical High $588.84 | Professional | None | $263.03 | $380.19 | $588.84 |
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 $151.36 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $34.67 | $34.67 |
Where Arkansas sits
The same service costs 3.9 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· 22nd of 51
$457
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.