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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | None | $371.54 | $416.87 | $416.87 |
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 $446.68 Median $537.03 Typical High $3,630.78 | Facility | None | $446.68 | $537.03 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $489.78 Typical High $4,265.80 | Professional | None | $269.15 | $489.78 | $4,265.80 |
United Setting Facility Modifier None Typical Low $371.54 Median $741.31 Typical High $741.31 | Facility | None | $371.54 | $741.31 | $741.31 |
United Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $478.63 | Professional | None | $213.80 | $323.59 | $478.63 |
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 $186.21 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $41.69 |
Where Oklahoma sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 33rd of 51
$417
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.