How much rates vary
Facilitymedian $501 · 10th to 90th $309 to $1,995Professionalmedian $407 · 10th to 90th $288 to $617
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 $380.19 Median $1,698.24 Typical High $2,511.89 | Facility | None | $380.19 | $1,698.24 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $398.11 | Professional | None | $316.23 | $380.19 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Facility | None | $501.19 | $501.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $645.65 | Professional | None | $338.84 | $512.86 | $645.65 |
Qualchoice Setting Professional Modifier None Typical Low $234.42 Median $562.34 Typical High $562.34 | Professional | None | $234.42 | $562.34 | $562.34 |
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 $281.84 Median $407.38 Typical High $645.65 | Professional | None | $281.84 | $407.38 | $645.65 |
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 $165.96 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $66.07 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $38.02 |
Where Arkansas sits
The same service costs 6.1 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.
Physician feeFacility fee
AK $5,496MD $901
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.