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 $29.51 Median $41.69 Typical High $41.69 | Facility | None | $29.51 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $30.20 | Professional | None | $29.51 | $29.51 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $36.31 | Facility | None | $26.30 | $26.30 | $36.31 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $36.31 | Professional | None | $26.92 | $31.62 | $36.31 |
United Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $33.11 | Professional | None | $25.70 | $30.20 | $33.11 |
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 $14.79 Median $14.79 Typical High $15.14 | Professional | 52 · Reduced service | $14.79 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $6.03 | Professional | 53 · Discontinued | $5.89 | $5.89 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.47 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.02 |
Where Oklahoma sits
The same service costs 4.7 times more in Alaska than in Hawaii. 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· 34th of 51
$30.90
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.