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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $131.83 | Professional | None | $114.82 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $1,174.90 | Facility | None | $138.04 | $165.96 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $1,479.11 | Professional | None | $93.33 | $165.96 | $1,479.11 |
United Setting Facility Modifier None Typical Low $147.91 Median $257.04 Typical High $257.04 | Facility | None | $147.91 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $158.49 | Professional | None | $74.13 | $109.65 | $158.49 |
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 $57.54 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $57.54 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $22.91 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.48 | $13.18 | $13.18 |
Where Oklahoma sits
The same service costs 3.5 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
$132
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.