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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $28.18 Typical High $46.77 | Facility | None | $20.89 | $28.18 | $46.77 |
Medica Setting Professional Modifier None Typical Low $12.02 Median $22.91 Typical High $257.04 | Professional | None | $12.02 | $22.91 | $257.04 |
United Setting Professional Modifier None Typical Low $9.55 Median $12.02 Typical High $22.91 | Professional | None | $9.55 | $12.02 | $22.91 |
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 $9.77 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $9.77 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 54 · Surgery only | $14.79 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $2.95 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.00 |
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· 47th of 51
$14.13
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.