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 $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier None Typical Low $0.71 Median $2.57 Typical High $2.57 | Professional | None | $0.71 | $2.57 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $2.88 Typical High $2.88 | Facility | None | $1.55 | $2.88 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $2.88 Typical High $5.50 | Professional | None | $2.82 | $2.88 | $5.50 |
Medica Setting Facility Modifier None Typical Low $2.09 Median $2.82 Typical High $79.43 | Facility | None | $2.09 | $2.82 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.85 Median $1.29 Typical High $2.04 | Professional | None | $0.85 | $1.29 | $2.04 |
Midlands Setting Professional Modifier None Typical Low $2.82 Median $2.88 Typical High $5.50 | Professional | None | $2.82 | $2.88 | $5.50 |
Midlands Setting Professional Modifier None Typical Low $3.63 Median $5.50 Typical High $7.08 | Professional | None | $3.63 | $5.50 | $7.08 |
United Setting Professional Modifier None Typical Low $0.93 Median $1.23 Typical High $1.66 | Professional | None | $0.93 | $1.23 | $1.66 |
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 $0.85 Median $1.29 Typical High $1.29 | Professional | 52 · Reduced service | $0.85 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.34 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.39 Typical High $0.39 | Professional | 55 · Aftercare only | $0.26 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.17 | $0.26 | $0.26 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | KX · Policy requirements met | $2.40 | $2.40 | $2.40 |
Where Nebraska sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 16th of 51
$2.04
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.