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 $40.74 Median $60.26 Typical High $60.26 | Facility | None | $40.74 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | None | $38.90 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $100.00 Typical High $107.15 | Facility | None | $57.54 | $100.00 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medica Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $53.70 | Facility | None | $32.36 | $32.36 | $53.70 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $43.65 | Professional | None | $35.48 | $38.90 | $43.65 |
United Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $44.67 | Professional | None | $33.88 | $39.81 | $44.67 |
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 $19.05 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $19.05 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $7.76 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $5.75 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.89 | $4.07 | $4.07 |
Where Oklahoma sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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
$38.90
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.