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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | None | $478.63 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,258.93 Typical High $1,348.96 | Facility | None | $707.95 | $1,258.93 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $676.08 | Facility | None | $245.47 | $245.47 | $676.08 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $1,949.84 | Professional | None | $371.54 | $436.52 | $1,949.84 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
United Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $446.68 | Professional | None | $338.84 | $398.11 | $446.68 |
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 $239.88 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $363.08 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $51.29 |
Where Oklahoma sits
The same service costs 1.8 times more in Wyoming 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· 49th of 51
$447
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.