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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | None | $14.13 | $14.13 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Medica Setting Facility Modifier None Typical Low $15.49 Median $22.39 Typical High $158.49 | Facility | None | $15.49 | $22.39 | $158.49 |
Medica Setting Professional Modifier None Typical Low $16.22 Median $30.20 Typical High $213.80 | Professional | None | $16.22 | $30.20 | $213.80 |
United Setting Professional Modifier None Typical Low $12.88 Median $17.38 Typical High $36.31 | Professional | None | $12.88 | $17.38 | $36.31 |
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 $7.08 Median $7.08 Typical High $7.41 | Professional | 52 · Reduced service | $7.08 | $7.08 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $2.95 | Professional | 53 · Discontinued | $2.82 | $2.82 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.24 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.48 |
Where Oklahoma sits
The same service costs 8.9 times more in North Dakota 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· 43rd of 51
$25.70
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.