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 $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | None | $0.95 | $0.95 | $0.95 |
Cigna Setting Professional Modifier None Typical Low $1.05 Median $1.12 Typical High $2.04 | Professional | None | $1.05 | $1.12 | $2.04 |
Medica Setting Facility Modifier None Typical Low $0.79 Median $1.51 Typical High $79.43 | Facility | None | $0.79 | $1.51 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.36 Median $0.48 Typical High $1.05 | Professional | None | $0.36 | $0.48 | $1.05 |
Midlands Setting Professional Modifier None Typical Low $1.05 Median $1.07 Typical High $2.04 | Professional | None | $1.05 | $1.07 | $2.04 |
Midlands Setting Professional Modifier None Typical Low $1.20 Median $2.04 Typical High $2.40 | Professional | None | $1.20 | $2.04 | $2.40 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.46 Typical High $0.71 | Professional | None | $0.35 | $0.46 | $0.71 |
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 $0.48 Median $0.48 Typical High $0.48 | Professional | 52 · Reduced service | $0.48 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 53 · Discontinued | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Where Nebraska sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$0.74
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.