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 $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | None | $5.01 | $5.13 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Medica Setting Facility Modifier None Typical Low $5.13 Median $5.25 Typical High $11.48 | Facility | None | $5.13 | $5.25 | $11.48 |
Medica Setting Professional Modifier None Typical Low $3.55 Median $6.03 Typical High $50.12 | Professional | None | $3.55 | $6.03 | $50.12 |
United Setting Professional Modifier None Typical Low $2.82 Median $3.55 Typical High $6.03 | Professional | None | $2.82 | $3.55 | $6.03 |
2 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 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.50 | $0.51 | $0.51 |
Where Oklahoma sits
The same service costs 2.7 times more in Hawaii than in Colorado. 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· 41st of 51
$5.13
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.