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 $602.56 Median $2,511.89 Typical High $7,585.78 | Facility | None | $602.56 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $223.87 | Professional | None | $95.50 | $177.83 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $724.44 Typical High $870.96 | Facility | None | $407.38 | $724.44 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $239.88 | Professional | None | $107.15 | $141.25 | $239.88 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $302.00 Typical High $3,981.07 | Facility | None | $131.83 | $302.00 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $812.83 Typical High $1,548.82 | Professional | None | $177.83 | $812.83 | $1,548.82 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,995.26 Typical High $3,630.78 | Facility | None | $467.74 | $1,995.26 | $3,630.78 |
United Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $229.09 | Professional | None | $79.43 | $154.88 | $229.09 |
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 $47.86 Median $77.62 Typical High $112.20 | Professional | 52 · Reduced service | $47.86 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $19.05 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $70.79 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $22.91 Typical High $33.88 | Professional | 55 · Aftercare only | $14.45 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.55 | $15.49 | $22.39 |
Where Oklahoma sits
The same service costs 4.2 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· 20th of 51
$214
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.