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 $213.80 Median $263.03 Typical High $2,570.40 | Professional | None | $213.80 | $263.03 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $204.17 Typical High $467.74 | Facility | None | $173.78 | $204.17 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $354.81 | Professional | None | $234.42 | $302.00 | $354.81 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $338.84 Typical High $1,737.80 | Facility | None | $114.82 | $338.84 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $3,090.30 | Professional | None | $234.42 | $371.54 | $3,090.30 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $371.54 | Professional | None | $199.53 | $257.04 | $371.54 |
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 $107.15 Median $109.65 Typical High $131.83 | Professional | 52 · Reduced service | $107.15 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | 53 · Discontinued | $43.65 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.88 Typical High $26.30 | Professional | 56 · Pre-op care only | $21.38 | $21.88 | $26.30 |
Where Oklahoma sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 32nd of 51
$302
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.