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 $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $9.12 Typical High $12.02 | Professional | None | $2.82 | $9.12 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $10.23 Typical High $10.23 | Facility | None | $5.50 | $10.23 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $10.23 Typical High $19.50 | Professional | None | $10.00 | $10.23 | $19.50 |
Medica Setting Facility Modifier None Typical Low $7.41 Median $10.00 Typical High $79.43 | Facility | None | $7.41 | $10.00 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $4.57 Typical High $7.08 | Professional | None | $3.02 | $4.57 | $7.08 |
Midlands Setting Professional Modifier None Typical Low $10.00 Median $10.23 Typical High $19.50 | Professional | None | $10.00 | $10.23 | $19.50 |
Midlands Setting Professional Modifier None Typical Low $12.59 Median $19.50 Typical High $25.12 | Professional | None | $12.59 | $19.50 | $25.12 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.27 Typical High $5.75 | Professional | None | $3.24 | $4.27 | $5.75 |
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 $3.02 Median $4.57 Typical High $6.03 | Professional | 52 · Reduced service | $3.02 | $4.57 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.82 Typical High $2.40 | Professional | 53 · Discontinued | $1.20 | $1.82 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $1.38 Typical High $1.82 | Professional | 55 · Aftercare only | $0.89 | $1.38 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.91 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.60 | $0.91 | $1.20 |
Where Nebraska sits
The same service costs 2.3 times more in Kansas than in Alabama. 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· 18th 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.