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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | None | $102.33 | $102.33 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $1,071.52 | Facility | None | $117.49 | $141.25 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $1,258.93 | Professional | None | $83.18 | $144.54 | $1,258.93 |
United Setting Facility Modifier None Typical Low $63.10 Median $234.42 Typical High $234.42 | Facility | None | $63.10 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $144.54 | Professional | None | $67.61 | $100.00 | $144.54 |
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 $51.29 Median $51.29 Typical High $53.70 | Professional | 52 · Reduced service | $51.29 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $20.42 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $16.22 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.72 |
Where Oklahoma sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 41st of 51
$112
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.