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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $102.33 | Professional | None | $83.18 | $83.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $114.82 Typical High $1,000.00 | Facility | None | $95.50 | $114.82 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $1,174.90 | Professional | None | $75.86 | $131.83 | $1,174.90 |
United Setting Facility Modifier None Typical Low $87.10 Median $213.80 Typical High $213.80 | Facility | None | $87.10 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $131.83 | Professional | None | $61.66 | $87.10 | $131.83 |
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 $41.69 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | 53 · Discontinued | $16.60 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.71 |
Where Oklahoma sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 47th of 51
$100
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.