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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $263.03 | Professional | None | $229.09 | $263.03 | $263.03 |
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 $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $331.13 Typical High $2,630.27 | Facility | None | $275.42 | $331.13 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $3,090.30 | Professional | None | $199.53 | $346.74 | $3,090.30 |
United Setting Facility Modifier None Typical Low $239.88 Median $562.34 Typical High $562.34 | Facility | None | $239.88 | $562.34 | $562.34 |
United Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $346.74 | Professional | None | $158.49 | $239.88 | $346.74 |
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 $114.82 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $114.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $45.71 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $34.67 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $26.30 |
Where Oklahoma sits
The same service costs 2.6 times more in Hawaii than in Alabama. 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· 49th of 51
$269
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.