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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $141.25 | Professional | None | $70.79 | $107.15 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $229.09 | Professional | None | $117.49 | $120.23 | $229.09 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $117.49 Typical High $512.86 | Facility | None | $87.10 | $117.49 | $512.86 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $53.70 Typical High $89.13 | Professional | None | $36.31 | $53.70 | $89.13 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $229.09 | Professional | None | $117.49 | $120.23 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $295.12 | Professional | None | $151.36 | $229.09 | $295.12 |
United Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $70.79 | Professional | None | $38.02 | $52.48 | $70.79 |
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 $35.48 Median $53.70 Typical High $70.79 | Professional | 52 · Reduced service | $35.48 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $21.88 Typical High $28.84 | Professional | 53 · Discontinued | $14.13 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $16.22 Typical High $21.38 | Professional | 55 · Aftercare only | $10.72 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.72 Typical High $14.13 | Professional | 56 · Pre-op care only | $7.08 | $10.72 | $14.13 |
Where Nebraska sits
The same service costs 2.5 times more in Idaho 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· 16th of 51
$85.11
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.