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 $954.99 Median $1,698.24 Typical High $2,511.89 | Facility | None | $954.99 | $1,698.24 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $954.99 | Professional | None | $831.76 | $954.99 | $954.99 |
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 $851.14 Median $1,288.25 Typical High $1,621.81 | Professional | None | $851.14 | $1,288.25 | $1,621.81 |
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 $707.95 Median $1,000.00 Typical High $1,621.81 | Professional | None | $707.95 | $1,000.00 | $1,621.81 |
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 $416.87 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $416.87 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $165.96 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $616.60 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $123.03 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $83.18 | $95.50 | $95.50 |
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· 40th 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.