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 $1,202.26 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,202.26 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $1,258.93 | Facility | None | $549.54 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,412.54 | Professional | None | $954.99 | $1,412.54 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $1,380.38 Typical High $6,309.57 | Facility | None | $269.15 | $1,380.38 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $8,511.38 | Professional | None | $977.24 | $1,288.25 | $8,511.38 |
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 $870.96 Median $1,071.52 Typical High $1,621.81 | Professional | None | $870.96 | $1,071.52 | $1,621.81 |
3 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 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $120.23 |
Where Oklahoma sits
The same service costs 5.6 times more in Alaska than in New York. 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· 36th of 51
$1,288
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.