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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | None | $95.50 | $109.65 | $109.65 |
BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $1,148.15 | Facility | None | $114.82 | $138.04 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $1,318.26 | Professional | None | $85.11 | $144.54 | $1,318.26 |
United Setting Facility Modifier None Typical Low $107.15 Median $234.42 Typical High $234.42 | Facility | None | $107.15 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $144.54 | Professional | None | $67.61 | $100.00 | $144.54 |
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 $47.86 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $47.86 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $19.05 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $14.13 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $9.55 | $10.96 | $10.96 |
Where Oklahoma sits
The same service costs 2.7 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· 34th of 51
$132
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.