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 $8,511.38 Median $12,022.64 Typical High $12,022.64 | Facility | None | $8,511.38 | $12,022.64 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,709.64 | Professional | None | $8,511.38 | $8,511.38 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Facility | None | $13,489.63 | $13,489.63 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Medica Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $9,549.93 | Facility | None | $6,760.83 | $6,760.83 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $7,079.46 Median $9,772.37 Typical High $37,153.52 | Professional | None | $7,079.46 | $9,772.37 | $37,153.52 |
United Setting Professional Modifier None Typical Low $7,413.10 Median $8,709.64 Typical High $9,772.37 | Professional | None | $7,413.10 | $8,709.64 | $9,772.37 |
4 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 $4,265.80 Median $4,265.80 Typical High $4,365.16 | Professional | 52 · Reduced service | $4,265.80 | $4,265.80 | $4,365.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | 53 · Discontinued | $1,698.24 | $1,698.24 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,288.25 Median $1,288.25 Typical High $1,318.26 | Professional | 55 · Aftercare only | $1,288.25 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | 56 · Pre-op care only | $851.14 | $851.14 | $870.96 |
Where Oklahoma sits
The same service costs 26.3 times more in Alaska 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.
Oklahoma· 31st of 51
$8,913
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.