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 $102.33 Median $114.82 Typical High $120.23 | Professional | None | $102.33 | $114.82 | $120.23 |
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 $117.49 Median $128.82 Typical High $151.36 | Professional | None | $117.49 | $128.82 | $151.36 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $457.09 Typical High $5,888.44 | Facility | None | $120.23 | $457.09 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $1,071.52 | Professional | None | $95.50 | $128.82 | $1,071.52 |
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 $91.20 Median $112.20 Typical High $165.96 | Professional | None | $91.20 | $112.20 | $165.96 |
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 $50.12 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $50.12 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $20.42 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $75.86 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $15.14 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $11.48 |
Where Oklahoma sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 33rd of 51
$129
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.