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 $11.48 Median $14.13 Typical High $36.31 | Facility | None | $11.48 | $14.13 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $30.20 | Professional | None | $10.00 | $14.13 | $30.20 |
BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $40.74 | Professional | None | $30.90 | $30.90 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $1,122.02 | Facility | None | $512.86 | $512.86 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $22.91 Typical High $52.48 | Professional | None | $11.75 | $22.91 | $52.48 |
United Setting Facility Modifier None Typical Low $75.86 Median $128.82 Typical High $707.95 | Facility | None | $75.86 | $128.82 | $707.95 |
United Setting Professional Modifier None Typical Low $9.12 Median $24.55 Typical High $50.12 | Professional | None | $9.12 | $24.55 | $50.12 |
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 $5.75 Median $6.92 Typical High $15.14 | Professional | 52 · Reduced service | $5.75 | $6.92 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.75 Typical High $6.03 | Professional | 53 · Discontinued | $2.29 | $2.75 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $10.23 Typical High $22.91 | Professional | 54 · Surgery only | $8.71 | $10.23 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $2.04 Typical High $4.57 | Professional | 55 · Aftercare only | $1.74 | $2.04 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.38 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.15 | $1.38 | $3.02 |
Where Arkansas sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 18th of 51
$32.36
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.