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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | None | $56.23 | $56.23 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $478.63 | Facility | None | $61.66 | $77.62 | $478.63 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $67.61 Typical High $616.60 | Professional | None | $38.90 | $67.61 | $616.60 |
United Setting Facility Modifier None Typical Low $40.74 Median $109.65 Typical High $109.65 | Facility | None | $40.74 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $31.62 Median $46.77 Typical High $67.61 | Professional | None | $31.62 | $46.77 | $67.61 |
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 $28.18 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.75 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.89 |
Where Oklahoma sits
The same service costs 2.5 times more in Arkansas 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· 33rd of 51
$58.88
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.