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 $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $4,570.88 Typical High $4,570.88 | Professional | None | $3,981.07 | $4,570.88 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $35,481.34 | Facility | None | $4,786.30 | $5,754.40 | $35,481.34 |
Medica Setting Professional Modifier None Typical Low $2,951.21 Median $5,248.07 Typical High $46,773.51 | Professional | None | $2,951.21 | $5,248.07 | $46,773.51 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $8,128.31 Typical High $8,128.31 | Facility | None | $2,884.03 | $8,128.31 | $8,128.31 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $5,248.07 | Professional | None | $2,344.23 | $3,548.13 | $5,248.07 |
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 $1,995.26 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,995.26 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $812.83 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $602.56 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $398.11 | $457.09 | $457.09 |
Where Oklahoma sits
The same service costs 2.3 times more in Arkansas than in Vermont. 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· 31st of 51
$4,571
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.