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 $3,890.45 Typical High $18,620.87 | Facility | None | $630.96 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $645.65 | Professional | None | $85.11 | $199.53 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $794.33 | Professional | None | $114.82 | $181.97 | $794.33 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $354.81 Typical High $5,370.32 | Facility | None | $128.82 | $354.81 | $5,370.32 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $2,570.40 Typical High $4,677.35 | Professional | None | $234.42 | $2,570.40 | $4,677.35 |
United Setting Facility Modifier None Typical Low $501.19 Median $2,754.23 Typical High $6,025.60 | Facility | None | $501.19 | $2,754.23 | $6,025.60 |
United Setting Professional Modifier None Typical Low $81.28 Median $190.55 Typical High $645.65 | Professional | None | $81.28 | $190.55 | $645.65 |
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 $42.66 Median $61.66 Typical High $323.59 | Professional | 52 · Reduced service | $42.66 | $61.66 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $24.55 Typical High $128.82 | Professional | 53 · Discontinued | $16.98 | $24.55 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $93.33 Typical High $489.78 | Professional | 54 · Surgery only | $63.10 | $93.33 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.62 Typical High $97.72 | Professional | 55 · Aftercare only | $12.59 | $18.62 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.30 Typical High $64.57 | Professional | 56 · Pre-op care only | $8.51 | $12.30 | $64.57 |
Where Oklahoma sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 8th of 51
$501
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.