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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | None | $89.13 | $89.13 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $239.88 | Professional | None | $87.10 | $109.65 | $239.88 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $165.96 Typical High $501.19 | Facility | None | $85.11 | $165.96 | $501.19 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $204.17 Typical High $602.56 | Professional | None | $91.20 | $204.17 | $602.56 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $245.47 | Professional | None | $87.10 | $123.03 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $245.47 | Professional | None | $109.65 | $158.49 | $245.47 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $87.10 | Facility | None | $77.62 | $77.62 | $87.10 |
United Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $245.47 | Professional | None | $91.20 | $177.83 | $245.47 |
5 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 $44.67 Median $44.67 Typical High $45.71 | Professional | 52 · Reduced service | $44.67 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $18.62 | Professional | 53 · Discontinued | $17.78 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.80 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $9.12 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | CG · Policy criteria applied | $91.20 | $91.20 | $91.20 |
Where Nebraska sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 9th of 51
$120
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.