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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $331.13 | Professional | None | $288.40 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $2,884.03 | Facility | None | $346.74 | $416.87 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $3,311.31 | Professional | None | $251.19 | $426.58 | $3,311.31 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $426.58 | Professional | None | $199.53 | $302.00 | $426.58 |
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 $144.54 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $144.54 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.84 | $33.11 | $33.11 |
Where Oklahoma sits
The same service costs 2.6 times more in Montana 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· 42nd of 51
$331
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.