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 $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,019.95 | $3,467.37 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $34,673.69 | Facility | None | $3,630.78 | $4,365.16 | $34,673.69 |
Medica Setting Professional Modifier None Typical Low $2,511.89 Median $4,466.84 Typical High $52,480.75 | Professional | None | $2,511.89 | $4,466.84 | $52,480.75 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $7,079.46 Typical High $7,079.46 | Facility | None | $4,073.80 | $7,079.46 | $7,079.46 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $4,365.16 | Professional | None | $2,041.74 | $3,019.95 | $4,365.16 |
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 $1,513.56 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,513.56 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $602.56 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $446.68 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $302.00 | $346.74 | $346.74 |
Where Oklahoma sits
The same service costs 3.9 times more in Hawaii 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· 44th of 51
$3,467
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.