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 $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | None | $12.88 | $12.88 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $17.78 Typical High $131.83 | Facility | None | $14.79 | $17.78 | $131.83 |
Medica Setting Professional Modifier None Typical Low $10.47 Median $18.20 Typical High $141.25 | Professional | None | $10.47 | $18.20 | $141.25 |
United Setting Facility Modifier None Typical Low $13.49 Median $29.51 Typical High $29.51 | Facility | None | $13.49 | $29.51 | $29.51 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $18.20 | Professional | None | $8.32 | $12.59 | $18.20 |
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 $6.46 Median $6.46 Typical High $6.76 | Professional | 52 · Reduced service | $6.46 | $6.46 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $2.69 | Professional | 53 · Discontinued | $2.57 | $2.57 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.35 |
Where Oklahoma sits
The same service costs 5.5 times more in Kansas 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· 47th of 51
$13.80
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.