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 $131.83 Median $3,890.45 Typical High $18,620.87 | Facility | None | $131.83 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $112.20 Typical High $144.54 | Professional | None | $61.66 | $112.20 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $63.10 | Facility | None | $61.66 | $61.66 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $134.90 Typical High $194.98 | Professional | None | $72.44 | $134.90 | $194.98 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $112.20 Typical High $194.98 | Facility | None | $63.10 | $112.20 | $194.98 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $549.54 Typical High $933.25 | Professional | None | $144.54 | $549.54 | $933.25 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $58.88 | Facility | None | $43.65 | $43.65 | $58.88 |
United Setting Professional Modifier None Typical Low $61.66 Median $125.89 Typical High $194.98 | Professional | None | $61.66 | $125.89 | $194.98 |
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 $30.90 Median $44.67 Typical High $69.18 | Professional | 52 · Reduced service | $30.90 | $44.67 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $17.78 Typical High $27.54 | Professional | 53 · Discontinued | $12.30 | $17.78 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $66.07 Typical High $102.33 | Professional | 54 · Surgery only | $45.71 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.49 Typical High $20.42 | Professional | 55 · Aftercare only | $9.33 | $13.49 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.91 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.17 | $8.91 | $13.80 |
Where Oklahoma sits
The same service costs 3.5 times more in Alaska 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· 16th of 51
$155
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.