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 $1,949.84 Median $5,623.41 Typical High $13,489.63 | Facility | None | $1,949.84 | $5,623.41 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $4,570.88 | Professional | None | $38.02 | $39.81 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $1,318.26 Typical High $11,220.18 | Facility | None | $269.15 | $1,318.26 | $11,220.18 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
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 $19.05 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.05 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $30.20 Typical High $30.20 | Professional | 54 · Surgery only | $28.84 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.75 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.80 | $3.98 | $3.98 |
Where Missouri sits
The same service costs 295.1 times more in Alaska than in West Virginia. 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.
Missouri· 18th of 51
$1,202
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.