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 $2.69 Median $2.69 Typical High $2.69 | Facility | None | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $363.08 | Facility | None | $141.25 | $169.82 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medica Setting Facility Modifier None Typical Low $2.69 Median $1,862.09 Typical High $1,862.09 | Facility | None | $2.69 | $1,862.09 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $5,370.32 | Professional | None | $2.45 | $2.45 | $5,370.32 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
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 $1.35 Median $1.35 Typical High $1.35 | Professional | 52 · Reduced service | $1.35 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 53 · Discontinued | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.27 |
Where Oklahoma sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 15th of 51
$126
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.