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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $38.02 Typical High $38.02 | Professional | None | $33.11 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $407.38 | Facility | None | $39.81 | $47.86 | $407.38 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $56.23 Typical High $512.86 | Professional | None | $32.36 | $56.23 | $512.86 |
United Setting Facility Modifier None Typical Low $19.95 Median $89.13 Typical High $89.13 | Facility | None | $19.95 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $25.70 Median $36.31 Typical High $56.23 | Professional | None | $25.70 | $36.31 | $56.23 |
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 $16.60 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $16.60 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $6.76 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.01 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.39 | $3.80 | $3.80 |
Where Oklahoma sits
The same service costs 2.8 times more in Montana than in New Jersey. 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· 45th of 51
$42.66
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.