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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | None | $107.15 | $107.15 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $144.54 Typical High $1,258.93 | Facility | None | $120.23 | $144.54 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $3,388.44 | Professional | None | $93.33 | $162.18 | $3,388.44 |
United Setting Facility Modifier None Typical Low $151.36 Median $263.03 Typical High $389.05 | Facility | None | $151.36 | $263.03 | $389.05 |
United Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $162.18 | Professional | None | $75.86 | $109.65 | $162.18 |
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 $52.48 Median $52.48 Typical High $54.95 | Professional | 52 · Reduced service | $52.48 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $16.60 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.96 |
Where Oklahoma sits
The same service costs 8.1 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· 41st of 51
$123
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.