How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $66.07 Median $162.18 Typical High $7,244.36 | Facility | None | $66.07 | $162.18 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $162.18 | Professional | None | $63.10 | $95.50 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $181.97 Typical High $2,137.96 | Facility | None | $120.23 | $181.97 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $123.03 Typical High $223.87 | Professional | None | $61.66 | $123.03 | $223.87 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $61.66 Median $117.49 Typical High $199.53 | Professional | None | $61.66 | $117.49 | $199.53 |
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 $31.62 Median $33.11 Typical High $79.43 | Professional | 52 · Reduced service | $31.62 | $33.11 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.49 Typical High $32.36 | Professional | 53 · Discontinued | $12.59 | $13.49 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $50.12 Typical High $120.23 | Professional | 54 · Surgery only | $47.86 | $50.12 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.00 Typical High $23.99 | Professional | 55 · Aftercare only | $9.55 | $10.00 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.61 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.31 | $6.61 | $16.22 |
Where Delaware sits
The same service costs 5.9 times more in Oklahoma 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.
Delaware· 31st of 51
$138
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.