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 $1,000.00 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,000.00 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $53.70 Typical High $575.44 | Facility | None | $52.48 | $53.70 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.72 Typical High $13.49 | Professional | None | $10.47 | $10.72 | $13.49 |
Medica Setting Facility Modifier None Typical Low $7.76 Median $12.59 Typical High $69.18 | Facility | None | $7.76 | $12.59 | $69.18 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $11.48 Typical High $380.19 | Professional | None | $6.92 | $11.48 | $380.19 |
United Setting Facility Modifier None Typical Low $56.23 Median $208.93 Typical High $331.13 | Facility | None | $56.23 | $208.93 | $331.13 |
United Setting Professional Modifier None Typical Low $6.61 Median $8.32 Typical High $14.79 | Professional | None | $6.61 | $8.32 | $14.79 |
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 $3.63 Median $3.72 Typical High $3.72 | Professional | 52 · Reduced service | $3.63 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.48 Median $1.48 Typical High $1.51 | Professional | 53 · Discontinued | $1.48 | $1.48 | $1.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | 54 · Surgery only | $5.50 | $5.50 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.10 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $1.10 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.74 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.72 | $0.74 | $0.76 |
Where Oklahoma sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 30th of 51
$10.72
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.