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 $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | None | $616.60 | $616.60 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $831.76 Typical High $7,079.46 | Facility | None | $707.95 | $831.76 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $8,709.64 | Professional | None | $562.34 | $954.99 | $8,709.64 |
United Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $1,548.82 | Facility | None | $630.96 | $1,548.82 | $1,548.82 |
United Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $954.99 | Professional | None | $446.68 | $645.65 | $954.99 |
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 $309.03 Median $309.03 Typical High $316.23 | Professional | 52 · Reduced service | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | 53 · Discontinued | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $63.10 |
Where Oklahoma sits
The same service costs 3.0 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· 49th of 51
$741
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.