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 $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $851.14 | Professional | None | $741.31 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $6,760.83 | Facility | None | $891.25 | $1,071.52 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $977.24 Typical High $8,511.38 | Professional | None | $537.03 | $977.24 | $8,511.38 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,479.11 Typical High $1,479.11 | Facility | None | $575.44 | $1,479.11 | $1,479.11 |
United Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $954.99 | Professional | None | $426.58 | $645.65 | $954.99 |
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 $371.54 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $85.11 | $85.11 |
Where Oklahoma sits
The same service costs 2.3 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· 32nd of 51
$851
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.