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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $309.03 | Professional | None | $295.12 | $295.12 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $2,951.21 | Facility | None | $338.84 | $407.38 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $3,715.35 | Professional | None | $234.42 | $398.11 | $3,715.35 |
United Setting Facility Modifier None Typical Low $269.15 Median $645.65 Typical High $645.65 | Facility | None | $269.15 | $645.65 | $645.65 |
United Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $398.11 | Professional | None | $186.21 | $281.84 | $398.11 |
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 $147.91 Median $147.91 Typical High $154.88 | Professional | 52 · Reduced service | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 53 · Discontinued | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $45.71 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $30.90 |
Where Oklahoma sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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
$309
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.