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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $72.44 Typical High $109.65 | Facility | None | $45.71 | $72.44 | $109.65 |
Medica Setting Professional Modifier None Typical Low $26.30 Median $50.12 Typical High $645.65 | Professional | None | $26.30 | $50.12 | $645.65 |
United Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $50.12 | Professional | None | $20.89 | $26.30 | $50.12 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $33.11 Typical High $33.11 | Professional | 54 · Surgery only | $32.36 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Where Oklahoma sits
The same service costs 2.8 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· 46th of 51
$31.62
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.