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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $46.77 | Professional | None | $41.69 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $512.86 | Facility | None | $50.12 | $60.26 | $512.86 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $69.18 Typical High $645.65 | Professional | None | $39.81 | $69.18 | $645.65 |
United Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $112.20 | Facility | None | $64.57 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $69.18 | Professional | None | $32.36 | $44.67 | $69.18 |
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 $20.89 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $20.89 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.32 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.17 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.17 | $4.68 | $4.68 |
Where Oklahoma sits
The same service costs 3.6 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· 45th of 51
$52.48
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.