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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | None | $177.83 | $177.83 | $186.21 |
BCBS Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $239.88 Typical High $1,584.89 | Facility | None | $204.17 | $239.88 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $1,949.84 | Professional | None | $125.89 | $218.78 | $1,949.84 |
United Setting Facility Modifier None Typical Low $125.89 Median $354.81 Typical High $354.81 | Facility | None | $125.89 | $354.81 | $354.81 |
United Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $218.78 | Professional | None | $100.00 | $151.36 | $218.78 |
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 $89.13 Median $89.13 Typical High $93.33 | Professional | 52 · Reduced service | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $37.15 | Professional | 53 · Discontinued | $35.48 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $27.54 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $18.62 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $18.62 |
Where Oklahoma sits
The same service costs 2.7 times more in Hawaii 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· 31st of 51
$186
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.