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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | None | $218.78 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $2,344.23 | Facility | None | $263.03 | $316.23 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $3,388.44 | Professional | None | $177.83 | $316.23 | $3,388.44 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $501.19 | Facility | None | $288.40 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $309.03 | Professional | None | $144.54 | $213.80 | $309.03 |
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 $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $109.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $43.65 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $33.11 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $21.88 | $25.12 | $25.12 |
Where Oklahoma sits
The same service costs 4.1 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· 41st of 51
$251
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.