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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $776.25 | Professional | None | $676.08 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $977.24 Typical High $7,079.46 | Facility | None | $812.83 | $977.24 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $9,332.54 | Professional | None | $575.44 | $977.24 | $9,332.54 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,584.89 Typical High $1,584.89 | Facility | None | $912.01 | $1,584.89 | $1,584.89 |
United Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $977.24 | Professional | None | $457.09 | $691.83 | $977.24 |
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 $338.84 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $77.62 | $77.62 |
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· 42nd of 51
$776
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.