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 $630.96 Median $2,511.89 Typical High $7,585.78 | Facility | None | $630.96 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $190.55 | Professional | None | $89.13 | $151.36 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
BCBS Setting Facility Modifier None Typical Low $575.44 Median $776.25 Typical High $1,122.02 | Facility | None | $575.44 | $776.25 | $1,122.02 |
BCBS Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $177.83 | Professional | None | $95.50 | $154.88 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $380.19 Typical High $489.78 | Facility | None | $316.23 | $380.19 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $208.93 | Professional | None | $100.00 | $141.25 | $208.93 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $229.09 Typical High $2,630.27 | Facility | None | $109.65 | $229.09 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $1,819.70 | Professional | None | $123.03 | $229.09 | $1,819.70 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,148.15 Typical High $2,454.71 | Facility | None | $269.15 | $1,148.15 | $2,454.71 |
United Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $218.78 | Professional | None | $74.13 | $125.89 | $218.78 |
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 $44.67 Median $44.67 Typical High $75.86 | Professional | 52 · Reduced service | $44.67 | $44.67 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.20 Typical High $30.90 | Professional | 53 · Discontinued | $17.78 | $18.20 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $67.61 Typical High $114.82 | Professional | 54 · Surgery only | $66.07 | $67.61 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $22.91 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $15.49 |
Where Oklahoma sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 22nd of 51
$178
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.