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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | None | $66.07 | $66.07 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $1,995.26 Typical High $6,309.57 | Facility | None | $72.44 | $1,995.26 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $512.86 | Professional | None | $74.13 | $117.49 | $512.86 |
United Setting Facility Modifier None Typical Low $501.19 Median $2,754.23 Typical High $6,025.60 | Facility | None | $501.19 | $2,754.23 | $6,025.60 |
United Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $128.82 | Professional | None | $69.18 | $87.10 | $128.82 |
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 $33.11 Median $33.11 Typical High $39.81 | Professional | 52 · Reduced service | $33.11 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $15.85 | Professional | 53 · Discontinued | $13.18 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $12.02 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $7.94 |
Where Oklahoma sits
The same service costs 12.6 times more in California than in Kentucky. 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· 25th of 51
$91.20
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.