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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | None | $74.13 | $74.13 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $676.08 | Facility | None | $85.11 | $102.33 | $676.08 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $891.25 | Professional | None | $53.70 | $91.20 | $891.25 |
United Setting Facility Modifier None Typical Low $79.43 Median $147.91 Typical High $147.91 | Facility | None | $79.43 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $91.20 | Professional | None | $42.66 | $64.57 | $91.20 |
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 $37.15 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $37.15 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $14.79 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.75 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.76 |
Where Oklahoma sits
The same service costs 5.1 times more in Kansas than in Florida. 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· 35th of 51
$77.62
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.