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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | None | $67.61 | $67.61 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $602.56 | Facility | None | $77.62 | $93.33 | $602.56 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $83.18 Typical High $794.33 | Professional | None | $47.86 | $83.18 | $794.33 |
United Setting Facility Modifier None Typical Low $77.62 Median $134.90 Typical High $134.90 | Facility | None | $77.62 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $83.18 | Professional | None | $38.90 | $57.54 | $83.18 |
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 $33.88 Median $33.88 Typical High $35.48 | Professional | 52 · Reduced service | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.72 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.08 |
Where Oklahoma sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 36th of 51
$70.79
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.