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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $66.07 | Professional | None | $44.67 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $478.63 Typical High $676.08 | Facility | None | $380.19 | $478.63 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $72.44 Typical High $93.33 | Professional | None | $45.71 | $72.44 | $93.33 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $741.31 | Facility | None | $79.43 | $131.83 | $741.31 |
United Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $97.72 | Professional | None | $43.65 | $56.23 | $97.72 |
4 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 $22.39 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $22.39 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $8.91 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $6.76 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.47 | $6.61 | $6.61 |
Where Arkansas sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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· 21st of 51
$77.62
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.