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 $1,000.00 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,000.00 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $275.42 | Professional | None | $229.09 | $263.03 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $724.44 Typical High $1,258.93 | Facility | None | $549.54 | $724.44 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $346.74 | Professional | None | $263.03 | $288.40 | $346.74 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $478.63 Typical High $5,888.44 | Facility | None | $263.03 | $478.63 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $4,365.16 | Professional | None | $223.87 | $295.12 | $4,365.16 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,025.60 | Facility | None | $426.58 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $380.19 | Professional | None | $204.17 | $257.04 | $380.19 |
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 $114.82 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $114.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $45.71 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $26.30 |
Where Oklahoma sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 32nd of 51
$288
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.