How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $120.23 Median $120.23 Typical High $1,995.26 | Facility | None | $120.23 | $120.23 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $181.97 | Professional | None | $112.20 | $120.23 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $239.88 | Facility | None | $208.93 | $208.93 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $331.13 | Professional | None | $128.82 | $234.42 | $331.13 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $676.08 Typical High $1,698.24 | Facility | None | $120.23 | $676.08 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $208.93 Typical High $891.25 | Professional | None | $102.33 | $208.93 | $891.25 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $239.88 | Professional | None | $102.33 | $165.96 | $239.88 |
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 $56.23 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $56.23 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $22.91 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $89.13 Typical High $107.15 | Professional | 54 · Surgery only | $85.11 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $16.98 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $14.13 |
Where North Dakota sits
The same service costs 6.0 times more in Alaska 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.
North Dakota· 13th of 51
$195
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.