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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $83.18 | Professional | None | $43.65 | $63.10 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $107.15 Typical High $107.15 | Facility | None | $46.77 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $204.17 | Professional | None | $83.18 | $104.71 | $204.17 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $104.71 Typical High $380.19 | Facility | None | $61.66 | $104.71 | $380.19 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $79.43 | Professional | None | $31.62 | $47.86 | $79.43 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $204.17 | Professional | None | $104.71 | $107.15 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $263.03 | Professional | None | $131.83 | $204.17 | $263.03 |
United Setting Facility Modifier None Typical Low $19.05 Median $83.18 Typical High $83.18 | Facility | None | $19.05 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $53.70 | Professional | None | $31.62 | $44.67 | $53.70 |
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 $21.88 Median $30.90 Typical High $41.69 | Professional | 52 · Reduced service | $21.88 | $30.90 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $12.59 Typical High $16.60 | Professional | 53 · Discontinued | $8.71 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.33 Typical High $12.30 | Professional | 55 · Aftercare only | $6.46 | $9.33 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.31 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.37 | $6.31 | $8.32 |
Where Nebraska sits
The same service costs 2.9 times more in Kansas than in Delaware. 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· 10th of 51
$74.13
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.