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 $41.69 Median $57.54 Typical High $57.54 | Facility | None | $41.69 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | None | $41.69 | $41.69 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $42.66 Typical High $45.71 | Facility | None | $41.69 | $42.66 | $45.71 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $42.66 Typical High $229.09 | Professional | None | $32.36 | $42.66 | $229.09 |
United Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $44.67 | Professional | None | $34.67 | $40.74 | $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 $20.42 Median $20.42 Typical High $21.38 | Professional | 52 · Reduced service | $20.42 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.31 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.27 |
Where Oklahoma sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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· 23rd of 51
$40.74
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.