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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.79 | Professional | None | $14.45 | $14.45 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medica Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $15.85 | Facility | None | $11.75 | $11.75 | $15.85 |
Medica Setting Professional Modifier None Typical Low $1.82 Median $10.47 Typical High $56.23 | Professional | None | $1.82 | $10.47 | $56.23 |
United Setting Professional Modifier None Typical Low $1.45 Median $1.82 Typical High $3.80 | Professional | None | $1.45 | $1.82 | $3.80 |
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 $7.24 Median $7.24 Typical High $7.41 | Professional | 52 · Reduced service | $7.24 | $7.24 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $2.95 | Professional | 53 · Discontinued | $2.88 | $2.88 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.24 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.48 |
Where Oklahoma sits
The same service costs 4.8 times more in Maryland than in Kentucky. 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· 33rd of 51
$13.49
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.