How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.78 Median $0.78 Typical High $0.78 | Facility | None | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | None | $0.78 | $0.78 | $0.78 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.87 Typical High $1.66 | Professional | None | $0.85 | $0.87 | $1.66 |
Medica Setting Facility Modifier None Typical Low $0.65 Median $1.23 Typical High $79.43 | Facility | None | $0.65 | $1.23 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.30 Median $0.39 Typical High $0.85 | Professional | None | $0.30 | $0.39 | $0.85 |
Midlands Setting Professional Modifier None Typical Low $0.85 Median $0.87 Typical High $1.66 | Professional | None | $0.85 | $0.87 | $1.66 |
Midlands Setting Professional Modifier None Typical Low $0.98 Median $1.66 Typical High $1.95 | Professional | None | $0.98 | $1.66 | $1.95 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.37 Typical High $0.59 | Professional | None | $0.28 | $0.37 | $0.59 |
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 $0.39 Median $0.39 Typical High $0.39 | Professional | 52 · Reduced service | $0.39 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Where Nebraska sits
The same service costs 2.6 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· 17th of 51
$0.62
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.