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 $630.96 Median $2,511.89 Typical High $7,585.78 | Facility | None | $630.96 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $457.09 | Professional | None | $169.82 | $331.13 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $1,202.26 | Facility | None | $407.38 | $1,000.00 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $478.63 | Professional | None | $190.55 | $257.04 | $478.63 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $537.03 Typical High $4,073.80 | Facility | None | $245.47 | $537.03 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $1,949.84 Typical High $3,090.30 | Professional | None | $363.08 | $1,949.84 | $3,090.30 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $4,265.80 | Facility | None | $467.74 | $2,041.74 | $4,265.80 |
United Setting Professional Modifier None Typical Low $141.25 Median $309.03 Typical High $478.63 | Professional | None | $141.25 | $309.03 | $478.63 |
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 $85.11 Median $147.91 Typical High $229.09 | Professional | 52 · Reduced service | $85.11 | $147.91 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $64.57 Typical High $91.20 | Professional | 53 · Discontinued | $34.67 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $218.78 Typical High $338.84 | Professional | 54 · Surgery only | $128.82 | $218.78 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $47.86 Typical High $67.61 | Professional | 55 · Aftercare only | $25.70 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $32.36 Typical High $45.71 | Professional | 56 · Pre-op care only | $16.98 | $32.36 | $45.71 |
Where Oklahoma sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 13th of 51
$457
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.