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 $758.58 Median $2,570.40 Typical High $7,585.78 | Facility | None | $758.58 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $66.07 | Professional | None | $53.70 | $63.10 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $302.00 Typical High $467.74 | Facility | None | $251.19 | $302.00 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $77.62 | Professional | None | $57.54 | $60.26 | $77.62 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $120.23 Typical High $1,584.89 | Facility | None | $70.79 | $120.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $478.63 | Professional | None | $47.86 | $63.10 | $478.63 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $79.43 | Professional | None | $42.66 | $52.48 | $79.43 |
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 $26.92 Median $31.62 Typical High $33.11 | Professional | 52 · Reduced service | $26.92 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $12.88 Typical High $13.18 | Professional | 53 · Discontinued | $10.72 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $47.86 Typical High $48.98 | Professional | 54 · Surgery only | $39.81 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.55 Typical High $9.77 | Professional | 55 · Aftercare only | $8.13 | $9.55 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.31 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.37 | $6.31 | $6.61 |
Where Oklahoma sits
The same service costs 4.2 times more in Alaska than in Florida. 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.
Oklahoma· 37th of 51
$60.26
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.