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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,819.70 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $21,379.62 | Facility | None | $2,187.76 | $2,630.27 | $21,379.62 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $2,884.03 Typical High $23,988.33 | Professional | None | $1,698.24 | $2,884.03 | $23,988.33 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $4,677.35 Typical High $4,677.35 | Facility | None | $2,398.83 | $4,677.35 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,905.46 | $2,884.03 |
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 $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $912.01 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $363.08 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $269.15 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $181.97 | $204.17 | $204.17 |
Where Oklahoma sits
The same service costs 2.1 times more in Montana than in South 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· 42nd of 51
$2,455
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.