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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | None | $380.19 | $380.19 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $512.86 Typical High $3,801.89 | Facility | None | $436.52 | $512.86 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $6,165.95 | Professional | None | $302.00 | $512.86 | $6,165.95 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $831.76 | Facility | None | $478.63 | $831.76 | $831.76 |
United Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $512.86 | Professional | None | $239.88 | $363.08 | $512.86 |
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 $190.55 Median $190.55 Typical High $199.53 | Professional | 52 · Reduced service | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | 53 · Discontinued | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $39.81 |
Where Oklahoma sits
The same service costs 4.6 times more in Hawaii 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· 46th of 51
$398
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.