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 $3,548.13 Median $9,549.93 Typical High $16,595.87 | Facility | None | $3,548.13 | $9,549.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $16,595.87 | Professional | None | $16,595.87 | $16,595.87 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $16,218.10 Typical High $17,378.01 | Facility | None | $1,737.80 | $16,218.10 | $17,378.01 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $8,128.31 Typical High $32,359.37 | Facility | None | $1,348.96 | $8,128.31 | $32,359.37 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $8,128.31 Typical High $26,915.35 | Facility | None | $1,348.96 | $8,128.31 | $26,915.35 |
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 $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | 52 · Reduced service | $8,317.64 | $8,317.64 | $8,317.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 53 · Discontinued | $3,311.31 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Professional | 54 · Surgery only | $12,589.25 | $12,589.25 | $12,589.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 55 · Aftercare only | $2,511.89 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 56 · Pre-op care only | $1,659.59 | $1,659.59 | $1,659.59 |
Where Kansas sits
The same service costs 371.5 times more in Wyoming than in Montana. 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.
Kansas· 30th of 51
$12,303
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.