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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $16.60 | Professional | None | $13.18 | $13.18 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $40.74 | Professional | None | $26.92 | $40.74 | $40.74 |
Medica Setting Facility Modifier None Typical Low $13.80 Median $616.60 Typical High $1,548.82 | Facility | None | $13.80 | $616.60 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $14.45 Median $20.89 Typical High $102.33 | Professional | None | $14.45 | $20.89 | $102.33 |
United Setting Facility Modifier None Typical Low $154.88 Median $891.25 Typical High $1,513.56 | Facility | None | $154.88 | $891.25 | $1,513.56 |
United Setting Professional Modifier None Typical Low $12.88 Median $16.98 Typical High $28.84 | Professional | None | $12.88 | $16.98 | $28.84 |
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 $6.61 Median $6.61 Typical High $8.32 | Professional | 52 · Reduced service | $6.61 | $6.61 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $3.31 | Professional | 53 · Discontinued | $2.63 | $2.63 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.51 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.66 |
Where Oklahoma sits
The same service costs 19.1 times more in Indiana than in Delaware. 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· 39th of 51
$19.05
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.