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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | None | $288.40 | $288.40 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $3,388.44 | Facility | None | $331.13 | $398.11 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $4,265.80 | Professional | None | $269.15 | $457.09 | $4,265.80 |
United Setting Facility Modifier None Typical Low $295.12 Median $741.31 Typical High $741.31 | Facility | None | $295.12 | $741.31 | $741.31 |
United Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $457.09 | Professional | None | $213.80 | $302.00 | $457.09 |
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 $144.54 Median $144.54 Typical High $151.36 | Professional | 52 · Reduced service | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | 53 · Discontinued | $58.88 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $30.20 |
Where Oklahoma sits
The same service costs 3.0 times more in Montana 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· 46th of 51
$339
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.