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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | None | $512.86 | $512.86 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $707.95 Typical High $5,128.61 | Facility | None | $588.84 | $707.95 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $6,165.95 | Professional | None | $407.38 | $691.83 | $6,165.95 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,122.02 Typical High $1,122.02 | Facility | None | $575.44 | $1,122.02 | $1,122.02 |
United Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $691.83 | Professional | None | $323.59 | $478.63 | $691.83 |
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 $257.04 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 53 · Discontinued | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $53.70 |
Where Oklahoma sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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
$550
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.