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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $15,135.61 | Facility | None | $1,548.82 | $1,862.09 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $19,054.61 | Professional | None | $1,174.90 | $2,041.74 | $19,054.61 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,311.31 Typical High $3,311.31 | Facility | None | $1,905.46 | $3,311.31 | $3,311.31 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,041.74 | Professional | None | $954.99 | $1,348.96 | $2,041.74 |
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 $630.96 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $630.96 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $190.55 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $144.54 |
Where Oklahoma sits
The same service costs 3.1 times more in Hawaii than in Pennsylvania. 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
$1,585
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.