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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | None | $426.58 | $426.58 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $588.84 Typical High $4,365.16 | Facility | None | $489.78 | $588.84 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $588.84 Typical High $5,248.07 | Professional | None | $338.84 | $588.84 | $5,248.07 |
United Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $954.99 | Facility | None | $478.63 | $954.99 | $954.99 |
United Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $588.84 | Professional | None | $269.15 | $407.38 | $588.84 |
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 $213.80 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $44.67 |
Where Oklahoma sits
The same service costs 3.2 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· 44th of 51
$447
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.