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 $81.28 Median $104.71 Typical High $131.83 | Professional | None | $81.28 | $104.71 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $144.54 | Professional | None | $104.71 | $120.23 | $144.54 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $1,548.82 | Facility | None | $104.71 | $131.83 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $912.01 | Professional | None | $95.50 | $162.18 | $912.01 |
United Setting Facility Modifier None Typical Low $165.96 Median $891.25 Typical High $1,548.82 | Facility | None | $165.96 | $891.25 | $1,548.82 |
United Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $154.88 | Professional | None | $74.13 | $97.72 | $154.88 |
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 $40.74 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $40.74 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.95 Typical High $26.30 | Professional | 53 · Discontinued | $16.22 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $74.13 Typical High $100.00 | Professional | 54 · Surgery only | $60.26 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $12.02 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.13 | $10.00 | $13.18 |
Where Oklahoma sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 24th of 51
$123
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.