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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | None | $13.49 | $13.49 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $20.89 Typical High $151.36 | Facility | None | $14.79 | $20.89 | $151.36 |
Medica Setting Professional Modifier None Typical Low $15.49 Median $30.20 Typical High $199.53 | Professional | None | $15.49 | $30.20 | $199.53 |
United Setting Professional Modifier None Typical Low $12.30 Median $16.22 Typical High $34.67 | Professional | None | $12.30 | $16.22 | $34.67 |
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 $6.76 Median $6.76 Typical High $7.08 | Professional | 52 · Reduced service | $6.76 | $6.76 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $2.82 | Professional | 53 · Discontinued | $2.69 | $2.69 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.09 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.35 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.35 | $1.35 | $1.41 |
Where Oklahoma sits
The same service costs 4.1 times more in Wyoming than in Utah. 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· 46th of 51
$20.89
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.