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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $66.07 | Professional | None | $64.57 | $64.57 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $87.10 Typical High $758.58 | Facility | None | $72.44 | $87.10 | $758.58 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $891.25 | Professional | None | $58.88 | $100.00 | $891.25 |
United Setting Facility Modifier None Typical Low $70.79 Median $162.18 Typical High $162.18 | Facility | None | $70.79 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $100.00 | Professional | None | $46.77 | $67.61 | $100.00 |
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 $32.36 Median $32.36 Typical High $33.11 | Professional | 52 · Reduced service | $32.36 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $13.18 | Professional | 53 · Discontinued | $12.88 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $10.00 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.61 |
Where Oklahoma sits
The same service costs 2.6 times more in Hawaii 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· 45th 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.