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 $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,754.40 | $5,754.40 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $5,754.40 Median $6,606.93 Typical High $6,606.93 | Professional | None | $5,754.40 | $6,606.93 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
Medica Setting Facility Modifier None Typical Low $6,918.31 Median $8,317.64 Typical High $63,095.73 | Facility | None | $6,918.31 | $8,317.64 | $63,095.73 |
Medica Setting Professional Modifier None Typical Low $5,128.61 Median $8,709.64 Typical High $81,283.05 | Professional | None | $5,128.61 | $8,709.64 | $81,283.05 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $14,125.38 Typical High $14,125.38 | Facility | None | $5,128.61 | $14,125.38 | $14,125.38 |
United Setting Professional Modifier None Typical Low $4,073.80 Median $6,025.60 Typical High $8,709.64 | Professional | None | $4,073.80 | $6,025.60 | $8,709.64 |
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 $2,884.03 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $2,884.03 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $1,148.15 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | 55 · Aftercare only | $851.14 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $575.44 | $660.69 | $660.69 |
Where Oklahoma sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 45th of 51
$6,761
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.