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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $56.23 | Professional | None | $48.98 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $70.79 Typical High $537.03 | Facility | None | $58.88 | $70.79 | $537.03 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $575.44 | Professional | None | $42.66 | $72.44 | $575.44 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $72.44 | Professional | None | $33.88 | $51.29 | $72.44 |
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 $24.55 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $24.55 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $9.77 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $7.41 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.90 | $5.62 | $5.62 |
Where Oklahoma sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 39th of 51
$72.44
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.