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 $144.54 Median $177.83 Typical High $2,570.40 | Professional | None | $144.54 | $177.83 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $112.20 Typical High $467.74 | Facility | None | $93.33 | $112.20 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $251.19 | Professional | None | $165.96 | $213.80 | $251.19 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $239.88 Typical High $2,398.83 | Facility | None | $177.83 | $239.88 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $1,047.13 Typical High $1,318.26 | Professional | None | $177.83 | $1,047.13 | $1,318.26 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,258.93 Typical High $2,454.71 | Facility | None | $269.15 | $1,258.93 | $2,454.71 |
United Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $263.03 | Professional | None | $134.90 | $181.97 | $263.03 |
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 $72.44 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $72.44 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $35.48 Typical High $43.65 | Professional | 53 · Discontinued | $28.84 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $109.65 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $21.88 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.78 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.45 | $17.78 | $21.88 |
Where Oklahoma sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 19th of 51
$240
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.