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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $131.83 | Professional | None | $48.98 | $53.70 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $60.26 Typical High $60.26 | Facility | None | $35.48 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $114.82 | Professional | None | $58.88 | $63.10 | $114.82 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $53.70 Typical High $251.19 | Facility | None | $43.65 | $53.70 | $251.19 |
Medica Setting Professional Modifier None Typical Low $17.78 Median $26.92 Typical High $43.65 | Professional | None | $17.78 | $26.92 | $43.65 |
Midlands Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $114.82 | Professional | None | $58.88 | $58.88 | $114.82 |
Midlands Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Midlands Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $147.91 | Professional | None | $74.13 | $114.82 | $147.91 |
United Setting Professional Modifier None Typical Low $19.50 Median $26.92 Typical High $38.90 | Professional | None | $19.50 | $26.92 | $38.90 |
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 $17.78 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $17.78 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $10.72 Typical High $10.96 | Professional | 53 · Discontinued | $7.08 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $8.13 Typical High $8.32 | Professional | 55 · Aftercare only | $5.37 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.55 | $5.37 | $5.50 |
Where Nebraska sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 20th of 51
$41.69
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.