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 $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $9.33 Typical High $17.38 | Professional | None | $9.12 | $9.33 | $17.38 |
Medica Setting Facility Modifier None Typical Low $6.76 Median $12.88 Typical High $79.43 | Facility | None | $6.76 | $12.88 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.16 Median $4.07 Typical High $9.12 | Professional | None | $3.16 | $4.07 | $9.12 |
Midlands Setting Professional Modifier None Typical Low $9.12 Median $9.33 Typical High $17.38 | Professional | None | $9.12 | $9.33 | $17.38 |
Midlands Setting Professional Modifier None Typical Low $10.23 Median $17.38 Typical High $20.42 | Professional | None | $10.23 | $17.38 | $20.42 |
United Setting Professional Modifier None Typical Low $2.95 Median $3.89 Typical High $6.17 | Professional | None | $2.95 | $3.89 | $6.17 |
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 $4.07 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 53 · Discontinued | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.81 |
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
$6.46
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.