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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | None | $22.91 | $22.91 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $26.30 Typical High $27.54 | Facility | None | $19.95 | $26.30 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $22.39 | Professional | None | $16.22 | $22.39 | $22.39 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $24.55 Typical High $186.21 | Facility | None | $23.44 | $24.55 | $186.21 |
Medica Setting Professional Modifier None Typical Low $13.80 Median $23.99 Typical High $194.98 | Professional | None | $13.80 | $23.99 | $194.98 |
United Setting Professional Modifier None Typical Low $11.22 Median $16.60 Typical High $23.99 | Professional | None | $11.22 | $16.60 | $23.99 |
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 $3.47 Median $3.47 Typical High $3.55 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.34 |
Where Oklahoma sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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· 31st of 51
$22.39
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.