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 $239.88 Median $251.19 Typical High $316.23 | Professional | None | $239.88 | $251.19 | $316.23 |
BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $269.15 Median $316.23 Typical High $316.23 | Professional | None | $269.15 | $316.23 | $316.23 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $1,148.15 Typical High $5,888.44 | Facility | None | $251.19 | $1,148.15 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $4,365.16 | Professional | None | $204.17 | $263.03 | $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 $181.97 Median $229.09 Typical High $346.74 | Professional | None | $181.97 | $229.09 | $346.74 |
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 $181.97 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $181.97 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $44.67 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.12 Typical High $29.51 | Professional | 56 · Pre-op care only | $23.99 | $25.12 | $29.51 |
Where Oklahoma sits
The same service costs 8.1 times more in New York than in Missouri. 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· 31st of 51
$295
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.