How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $10.00 | Professional | None | $5.25 | $5.62 | $10.00 |
Medica Setting Facility Modifier None Typical Low $3.98 Median $7.41 Typical High $79.43 | Facility | None | $3.98 | $7.41 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.82 Median $2.40 Typical High $5.25 | Professional | None | $1.82 | $2.40 | $5.25 |
Midlands Setting Professional Modifier None Typical Low $5.25 Median $5.37 Typical High $10.00 | Professional | None | $5.25 | $5.37 | $10.00 |
Midlands Setting Professional Modifier None Typical Low $5.89 Median $10.00 Typical High $12.02 | Professional | None | $5.89 | $10.00 | $12.02 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.24 Typical High $3.55 | Professional | None | $1.74 | $2.24 | $3.55 |
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 $2.40 Median $2.40 Typical High $2.40 | Professional | 52 · Reduced service | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 53 · Discontinued | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $0.48 |
Where Nebraska sits
The same service costs 2.6 times more in Hawaii than in Maine. 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.
Nebraska· 17th of 51
$3.72
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.