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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $26.30 | Professional | None | $25.70 | $26.30 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $43.65 Typical High $66.07 | Facility | None | $26.92 | $43.65 | $66.07 |
Medica Setting Professional Modifier None Typical Low $15.49 Median $30.20 Typical High $398.11 | Professional | None | $15.49 | $30.20 | $398.11 |
United Setting Professional Modifier None Typical Low $12.30 Median $15.49 Typical High $30.20 | Professional | None | $12.30 | $15.49 | $30.20 |
5 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 $12.88 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $12.88 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $5.13 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 54 · Surgery only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.63 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.57 | $2.63 | $2.63 |
Where Oklahoma sits
The same service costs 2.7 times more in Hawaii 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· 49th of 51
$18.62
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.