How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $69.18 | Professional | None | $54.95 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $331.13 Typical High $363.08 | Facility | None | $190.55 | $331.13 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $69.18 Typical High $5,011.87 | Facility | None | $54.95 | $69.18 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $4,897.79 | Professional | None | $1,445.44 | $1,445.44 | $4,897.79 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
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 $27.54 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $27.54 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $10.96 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $8.13 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.50 | $6.92 | $6.92 |
Where Oklahoma sits
The same service costs 26.9 times more in Kansas 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· 28th of 51
$126
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.