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 $8.91 Median $12.59 Typical High $12.59 | Facility | None | $8.91 | $12.59 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | None | $8.91 | $8.91 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Medica Setting Facility Modifier None Typical Low $9.33 Median $9.55 Typical High $15.85 | Facility | None | $9.33 | $9.55 | $15.85 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $10.96 | Professional | None | $8.32 | $9.12 | $10.96 |
United Setting Professional Modifier None Typical Low $7.76 Median $9.12 Typical High $9.12 | Professional | None | $7.76 | $9.12 | $9.12 |
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 $4.47 Median $4.47 Typical High $4.57 | Professional | 52 · Reduced service | $4.47 | $4.47 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $1.78 Typical High $1.82 | Professional | 53 · Discontinued | $1.78 | $1.78 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.35 Typical High $1.38 | Professional | 55 · Aftercare only | $1.35 | $1.35 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $0.89 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.89 | $0.89 | $0.91 |
Where Oklahoma sits
The same service costs 1.8 times more in Alaska than in Montana. 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· 36th of 51
$9.12
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.