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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $245.47 | Professional | None | $239.88 | $239.88 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $2,818.38 | Facility | None | $269.15 | $323.59 | $2,818.38 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $3,630.78 | Professional | None | $218.78 | $371.54 | $3,630.78 |
United Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $602.56 | Facility | None | $346.74 | $602.56 | $602.56 |
United Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $371.54 | Professional | None | $173.78 | $251.19 | $371.54 |
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 $120.23 Median $120.23 Typical High $123.03 | Professional | 52 · Reduced service | $120.23 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 53 · Discontinued | $47.86 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $37.15 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $24.55 |
Where Oklahoma sits
The same service costs 4.5 times more in Hawaii than in Kansas. 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· 43rd of 51
$288
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.