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 $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.16 | Professional | None | $3.09 | $3.09 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $2.24 Median $3.55 Typical High $3.72 | Facility | None | $2.24 | $3.55 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Medica Setting Facility Modifier None Typical Low $3.16 Median $3.24 Typical High $79.43 | Facility | None | $3.16 | $3.24 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.86 Median $3.24 Typical High $26.30 | Professional | None | $1.86 | $3.24 | $26.30 |
United Setting Professional Modifier None Typical Low $1.48 Median $2.19 Typical High $3.24 | Professional | None | $1.48 | $2.19 | $3.24 |
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 $1.55 Median $1.55 Typical High $1.58 | Professional | 52 · Reduced service | $1.55 | $1.55 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.63 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.47 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.31 |
Where Oklahoma sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 37th of 51
$3.09
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.