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 $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $10,000.00 Median $11,220.18 Typical High $11,220.18 | Professional | None | $10,000.00 | $11,220.18 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
Medica Setting Facility Modifier None Typical Low $11,748.98 Median $14,454.40 Typical High $91,201.08 | Facility | None | $11,748.98 | $14,454.40 | $91,201.08 |
Medica Setting Professional Modifier None Typical Low $7,244.36 Median $13,182.57 Typical High $114,815.36 | Professional | None | $7,244.36 | $13,182.57 | $114,815.36 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $20,417.38 Typical High $20,417.38 | Facility | None | $7,943.28 | $20,417.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $5,888.44 Median $8,709.64 Typical High $13,182.57 | Professional | None | $5,888.44 | $8,709.64 | $13,182.57 |
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 $1,995.26 Median $2,238.72 Typical High $2,238.72 | Professional | 53 · Discontinued | $1,995.26 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,479.11 Median $1,698.24 Typical High $1,698.24 | Professional | 55 · Aftercare only | $1,479.11 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $1,000.00 | $1,122.02 | $1,122.02 |
Where Oklahoma sits
The same service costs 2.5 times more in Montana than in Florida. 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· 30th 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.