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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $30.20 | Professional | None | $29.51 | $29.51 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $39.81 Typical High $323.59 | Facility | None | $33.88 | $39.81 | $323.59 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $44.67 Typical High $398.11 | Professional | None | $25.70 | $44.67 | $398.11 |
United Setting Facility Modifier None Typical Low $36.31 Median $72.44 Typical High $72.44 | Facility | None | $36.31 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $20.89 Median $30.90 Typical High $44.67 | Professional | None | $20.89 | $30.90 | $44.67 |
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 $14.79 Median $14.79 Typical High $15.14 | Professional | 52 · Reduced service | $14.79 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $6.17 | Professional | 53 · Discontinued | $5.89 | $5.89 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.02 |
Where Oklahoma sits
The same service costs 2.7 times more in Montana 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· 46th of 51
$34.67
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.