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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | None | $363.08 | $363.08 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $489.78 Typical High $4,168.69 | Facility | None | $407.38 | $489.78 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $5,011.87 | Professional | None | $331.13 | $562.34 | $5,011.87 |
United Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $912.01 | Facility | None | $478.63 | $912.01 | $912.01 |
United Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $562.34 | Professional | None | $263.03 | $380.19 | $562.34 |
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 $181.97 Median $181.97 Typical High $186.21 | Professional | 52 · Reduced service | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | 53 · Discontinued | $72.44 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $56.23 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $37.15 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $37.15 |
Where Oklahoma sits
The same service costs 3.2 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· 42nd of 51
$437
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.