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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | None | $295.12 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $426.58 Typical High $2,754.23 | Facility | None | $354.81 | $426.58 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $3,890.45 | Professional | None | $213.80 | $389.05 | $3,890.45 |
United Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $602.56 | Facility | None | $346.74 | $602.56 | $602.56 |
United Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $389.05 | Professional | None | $173.78 | $257.04 | $389.05 |
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 $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $58.88 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $29.51 | $33.11 | $33.11 |
Where Oklahoma sits
The same service costs 3.7 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· 31st of 51
$331
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.