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 $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $8.91 Typical High $10.00 | Professional | None | $2.45 | $8.91 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $10.00 Typical High $10.00 | Facility | None | $5.37 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $9.77 Typical High $19.05 | Professional | None | $8.91 | $9.77 | $19.05 |
Medica Setting Facility Modifier None Typical Low $7.24 Median $8.91 Typical High $79.43 | Facility | None | $7.24 | $8.91 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $4.47 Typical High $8.13 | Professional | None | $3.02 | $4.47 | $8.13 |
Midlands Setting Professional Modifier None Typical Low $9.77 Median $10.00 Typical High $19.05 | Professional | None | $9.77 | $10.00 | $19.05 |
Midlands Setting Professional Modifier None Typical Low $12.59 Median $19.05 Typical High $24.55 | Professional | None | $12.59 | $19.05 | $24.55 |
United Setting Professional Modifier None Typical Low $3.16 Median $4.27 Typical High $5.75 | Professional | None | $3.16 | $4.27 | $5.75 |
2 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 55 · Aftercare only Typical Low $0.87 Median $1.35 Typical High $1.51 | Professional | 55 · Aftercare only | $0.87 | $1.35 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.89 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.59 | $0.89 | $1.00 |
Where Nebraska sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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· 15th of 51
$7.08
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.