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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $25.12 | Professional | None | $23.99 | $23.99 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $37.15 Typical High $269.15 | Facility | None | $26.30 | $37.15 | $269.15 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $50.12 Typical High $354.81 | Professional | None | $27.54 | $50.12 | $354.81 |
United Setting Professional Modifier None Typical Low $21.88 Median $29.51 Typical High $61.66 | Professional | None | $21.88 | $29.51 | $61.66 |
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 $12.02 Median $12.02 Typical High $12.59 | Professional | 52 · Reduced service | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $5.01 | Professional | 53 · Discontinued | $4.79 | $4.79 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $2.51 |
Where Oklahoma sits
The same service costs 4.1 times more in Kansas than in Colorado. 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· 45th of 51
$36.31
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.