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 $6.17 Median $8.71 Typical High $8.71 | Facility | None | $6.17 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | None | $5.75 | $6.17 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Medica Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $6.46 | Facility | None | $5.50 | $5.50 | $6.46 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $25.12 | Professional | None | $5.75 | $6.03 | $25.12 |
United Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.75 Typical High $6.31 | Professional | None | $4.90 | $5.75 | $6.31 |
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 $2.88 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.88 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.15 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.93 Typical High $0.93 | Professional | 55 · Aftercare only | $0.87 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.58 | $0.62 | $0.62 |
Where Oklahoma sits
The same service costs 1.5 times more in Alaska than in Pennsylvania. 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
$5.75
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.