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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | None | $257.04 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $371.54 Typical High $2,754.23 | Facility | None | $309.03 | $371.54 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $3,162.28 | Professional | None | $218.78 | $380.19 | $3,162.28 |
United Setting Facility Modifier None Typical Low $257.04 Median $616.60 Typical High $616.60 | Facility | None | $257.04 | $616.60 | $616.60 |
United Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $380.19 | Professional | None | $173.78 | $263.03 | $380.19 |
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 $128.82 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $128.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $51.29 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.70 | $29.51 | $29.51 |
Where Oklahoma sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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
$295
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.