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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | None | $151.36 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $1,621.81 | Facility | None | $177.83 | $218.78 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $1,995.26 | Professional | None | $141.25 | $245.47 | $1,995.26 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $245.47 | Professional | None | $112.20 | $158.49 | $245.47 |
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 $74.13 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $22.39 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.14 | $16.98 | $16.98 |
Where Oklahoma sits
The same service costs 3.0 times more in Iowa than in New York. 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· 41st of 51
$234
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.