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 $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $6.46 Typical High $8.71 | Professional | None | $4.07 | $6.46 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $7.41 Typical High $7.41 | Facility | None | $3.89 | $7.41 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.41 Typical High $13.80 | Professional | None | $7.08 | $7.41 | $13.80 |
Medica Setting Facility Modifier None Typical Low $5.25 Median $6.46 Typical High $79.43 | Facility | None | $5.25 | $6.46 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.19 Median $3.24 Typical High $5.13 | Professional | None | $2.19 | $3.24 | $5.13 |
Midlands Setting Professional Modifier None Typical Low $7.08 Median $7.41 Typical High $13.80 | Professional | None | $7.08 | $7.41 | $13.80 |
Midlands Setting Professional Modifier None Typical Low $9.12 Median $13.80 Typical High $17.78 | Professional | None | $9.12 | $13.80 | $17.78 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.09 Typical High $4.27 | Professional | None | $2.34 | $3.09 | $4.27 |
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 $2.14 Median $3.24 Typical High $4.27 | Professional | 52 · Reduced service | $2.14 | $3.24 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $1.32 Typical High $1.74 | Professional | 53 · Discontinued | $0.85 | $1.32 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.98 Typical High $1.29 | Professional | 55 · Aftercare only | $0.65 | $0.98 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.65 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.43 | $0.65 | $0.85 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | KX · Policy requirements met | $6.03 | $6.03 | $6.03 |
Where Nebraska sits
The same service costs 2.1 times more in Montana 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
$5.13
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.