How much rates vary
Facilitymedian $501 · 10th to 90th $288 to $1,995Professionalmedian $295 · 10th to 90th $224 to $479
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 $288.40 Median $1,698.24 Typical High $2,511.89 | Facility | None | $288.40 | $1,698.24 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $302.00 | Professional | None | $239.88 | $288.40 | $302.00 |
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 $181.97 Median $389.05 Typical High $489.78 | Professional | None | $181.97 | $389.05 | $489.78 |
Qualchoice Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $213.80 Median $309.03 Typical High $489.78 | Professional | None | $213.80 | $309.03 | $489.78 |
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 $125.89 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $125.89 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $51.29 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $190.55 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $38.02 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.12 | $28.84 | $28.84 |
Where Arkansas sits
The same service costs 7.3 times more in Alaska than in Montana. 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 $5,199MT $710
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.