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 $2.00 Median $2.00 Typical High $2.00 | Facility | None | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $2.00 Typical High $2.63 | Professional | None | $0.62 | $2.00 | $2.63 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $2.24 Typical High $2.24 | Facility | None | $1.20 | $2.24 | $2.24 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.24 Typical High $4.27 | Professional | None | $2.19 | $2.24 | $4.27 |
Medica Setting Facility Modifier None Typical Low $1.58 Median $2.00 Typical High $79.43 | Facility | None | $1.58 | $2.00 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.66 Median $1.00 Typical High $1.55 | Professional | None | $0.66 | $1.00 | $1.55 |
Midlands Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $4.27 | Professional | None | $2.19 | $2.19 | $4.27 |
Midlands Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Facility | None | $2.24 | $2.24 | $2.24 |
Midlands Setting Professional Modifier None Typical Low $2.75 Median $4.27 Typical High $5.37 | Professional | None | $2.75 | $4.27 | $5.37 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.95 Typical High $1.29 | Professional | None | $0.71 | $0.95 | $1.29 |
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 $0.19 Median $0.30 Typical High $0.39 | Professional | 55 · Aftercare only | $0.19 | $0.30 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.20 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.13 | $0.20 | $0.26 |
Where Nebraska sits
The same service costs 2.1 times more in Kansas 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· 18th of 51
$1.55
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.