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 $3.80 Median $3.80 Typical High $7.59 | Facility | None | $3.80 | $3.80 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.98 | Professional | None | $3.80 | $3.80 | $3.98 |
Medica Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $8.71 | Facility | None | $7.08 | $7.08 | $8.71 |
Medica Setting Professional Modifier None Typical Low $2.57 Median $6.46 Typical High $7.24 | Professional | None | $2.57 | $6.46 | $7.24 |
United Setting Professional Modifier None Typical Low $2.34 Median $5.89 Typical High $5.89 | Professional | None | $2.34 | $5.89 | $5.89 |
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 $1.86 Median $1.86 Typical High $2.00 | Professional | 52 · Reduced service | $1.86 | $1.86 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $0.79 | Professional | 53 · Discontinued | $0.76 | $0.76 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.60 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.38 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.38 | $0.38 | $0.40 |
Where Nebraska sits
The same service costs 5.9 times more in Hawaii than in Arkansas. 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· 11th of 51
$5.89
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.