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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $125.89 | Professional | None | $50.12 | $123.03 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $134.90 Typical High $245.47 | Facility | None | $123.03 | $134.90 | $245.47 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $302.00 | Professional | None | $41.69 | $52.48 | $302.00 |
United Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $64.57 | Professional | None | $41.69 | $50.12 | $64.57 |
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 $25.12 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $25.12 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $10.00 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $18.62 Typical High $19.05 | Professional | 55 · Aftercare only | $7.59 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $12.30 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.25 | $12.30 | $12.59 |
Where Oklahoma sits
The same service costs 4.0 times more in Alaska than in Connecticut. 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· 32nd of 51
$50.12
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.