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 $208.93 Median $1,000.00 Typical High $2,041.74 | Facility | None | $208.93 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $489.78 Typical High $741.31 | Professional | None | $186.21 | $489.78 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $316.23 | Professional | None | $218.78 | $218.78 | $316.23 |
BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,513.56 Typical High $2,089.30 | Facility | None | $660.69 | $1,513.56 | $2,089.30 |
BCBS Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $912.01 | Professional | None | $165.96 | $218.78 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $549.54 Typical High $1,000.00 | Facility | None | $489.78 | $549.54 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $371.54 Typical High $1,096.48 | Professional | None | $186.21 | $371.54 | $1,096.48 |
Qualchoice Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,187.76 | Facility | None | $407.38 | $588.84 | $2,187.76 |
United Setting Professional Modifier None Typical Low $158.49 Median $549.54 Typical High $1,230.27 | Professional | None | $158.49 | $549.54 | $1,230.27 |
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 $104.71 Median $186.21 Typical High $371.54 | Professional | 52 · Reduced service | $104.71 | $186.21 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $74.13 Typical High $147.91 | Professional | 53 · Discontinued | $41.69 | $74.13 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $281.84 Typical High $549.54 | Professional | 54 · Surgery only | $154.88 | $281.84 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $56.23 Typical High $109.65 | Professional | 55 · Aftercare only | $31.62 | $56.23 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $37.15 Typical High $74.13 | Professional | 56 · Pre-op care only | $20.89 | $37.15 | $74.13 |
Where Arkansas sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 29th of 51
$617
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.