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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $11,481.54 | Facility | None | $1,348.96 | $1,621.81 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,698.24 Typical High $13,182.57 | Professional | None | $977.24 | $1,698.24 | $13,182.57 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,698.24 | Professional | None | $794.33 | $1,174.90 | $1,698.24 |
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 $562.34 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $128.82 | $128.82 |
Where Oklahoma sits
The same service costs 2.6 times more in Montana than in New York. 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· 40th of 51
$1,318
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.