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 $302.00 Median $426.58 Typical High $426.58 | Facility | None | $302.00 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | None | $302.00 | $302.00 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $323.59 Typical High $371.54 | Facility | None | $302.00 | $323.59 | $371.54 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $331.13 Typical High $1,258.93 | Professional | None | $144.54 | $331.13 | $1,258.93 |
United Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $346.74 | Professional | None | $263.03 | $309.03 | $346.74 |
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 $151.36 Median $151.36 Typical High $154.88 | Professional | 52 · Reduced service | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | 53 · Discontinued | $60.26 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.90 |
Where Oklahoma sits
The same service costs 2.3 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· 20th of 51
$324
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.