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 $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,365.16 | $5,011.87 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $4,786.30 Median $11,748.98 Typical High $44,668.36 | Facility | None | $4,786.30 | $11,748.98 | $44,668.36 |
Medica Setting Professional Modifier None Typical Low $3,801.89 Median $7,079.46 Typical High $51,286.14 | Professional | None | $3,801.89 | $7,079.46 | $51,286.14 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $7,079.46 | Professional | None | $3,019.95 | $4,570.88 | $7,079.46 |
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 $2,187.76 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,187.76 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $870.96 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $645.65 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $436.52 | $501.19 | $501.19 |
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· 48th of 51
$4,786
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.