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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | None | $218.78 | $218.78 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $302.00 Typical High $2,454.71 | Facility | None | $251.19 | $302.00 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $3,388.44 | Professional | None | $190.55 | $331.13 | $3,388.44 |
United Setting Facility Modifier None Typical Low $234.42 Median $537.03 Typical High $537.03 | Facility | None | $234.42 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $331.13 | Professional | None | $151.36 | $223.87 | $331.13 |
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 $109.65 Median $109.65 Typical High $114.82 | Professional | 52 · Reduced service | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | 53 · Discontinued | $43.65 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $34.67 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $22.91 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $22.91 |
Where Oklahoma sits
The same service costs 3.5 times more in Hawaii than in Florida. 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
$257
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.