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 $9,772.37 Median $9,772.37 Typical High $9,772.37 | Facility | None | $9,772.37 | $9,772.37 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $9,772.37 Median $11,220.18 Typical High $11,220.18 | Professional | None | $9,772.37 | $11,220.18 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Facility | None | $11,748.98 | $11,748.98 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
Medica Setting Facility Modifier None Typical Low $11,748.98 Median $14,125.38 Typical High $87,096.36 | Facility | None | $11,748.98 | $14,125.38 | $87,096.36 |
Medica Setting Professional Modifier None Typical Low $7,079.46 Median $12,882.50 Typical High $112,201.85 | Professional | None | $7,079.46 | $12,882.50 | $112,201.85 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $19,498.45 Typical High $19,498.45 | Facility | None | $7,585.78 | $19,498.45 | $19,498.45 |
United Setting Professional Modifier None Typical Low $5,623.41 Median $8,511.38 Typical High $12,589.25 | Professional | None | $5,623.41 | $8,511.38 | $12,589.25 |
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 $4,897.79 Median $5,623.41 Typical High $5,623.41 | Professional | 52 · Reduced service | $4,897.79 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,949.84 Median $2,238.72 Typical High $2,238.72 | Professional | 53 · Discontinued | $1,949.84 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,445.44 Median $1,659.59 Typical High $1,659.59 | Professional | 55 · Aftercare only | $1,445.44 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $977.24 Median $1,122.02 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $977.24 | $1,122.02 | $1,122.02 |
Where Oklahoma sits
The same service costs 2.6 times more in Montana than in New Jersey. 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· 29th of 51
$11,220
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.