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 $44.67 Median $44.67 Typical High $85.11 | Facility | None | $44.67 | $44.67 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $85.11 | Professional | None | $44.67 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $81.28 Typical High $114.82 | Facility | None | $66.07 | $81.28 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $104.71 | Professional | None | $52.48 | $74.13 | $104.71 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $114.82 Typical High $1,174.90 | Facility | None | $60.26 | $114.82 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $338.84 Typical High $645.65 | Professional | None | $72.44 | $338.84 | $645.65 |
United Setting Facility Modifier None Typical Low $85.11 Median $575.44 Typical High $1,380.38 | Facility | None | $85.11 | $575.44 | $1,380.38 |
United Setting Professional Modifier None Typical Low $38.02 Median $67.61 Typical High $97.72 | Professional | None | $38.02 | $67.61 | $97.72 |
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 $22.39 Median $22.39 Typical High $42.66 | Professional | 52 · Reduced service | $22.39 | $22.39 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $16.98 | Professional | 53 · Discontinued | $8.91 | $8.91 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $12.88 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $8.51 |
Where Oklahoma sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 20th of 51
$85.11
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.