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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $138.04 | Professional | None | $72.44 | $104.71 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $181.97 Typical High $181.97 | Facility | None | $77.62 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $346.74 | Professional | None | $151.36 | $177.83 | $346.74 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $177.83 Typical High $645.65 | Facility | None | $102.33 | $177.83 | $645.65 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $125.89 | Professional | None | $53.70 | $81.28 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $346.74 | Professional | None | $177.83 | $177.83 | $346.74 |
Midlands Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $446.68 | Professional | None | $223.87 | $346.74 | $446.68 |
United Setting Facility Modifier None Typical Low $60.26 Median $141.25 Typical High $141.25 | Facility | None | $60.26 | $141.25 | $141.25 |
United Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $91.20 | Professional | None | $53.70 | $75.86 | $91.20 |
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 $36.31 Median $52.48 Typical High $69.18 | Professional | 52 · Reduced service | $36.31 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $20.89 Typical High $27.54 | Professional | 53 · Discontinued | $14.45 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.85 Typical High $20.89 | Professional | 55 · Aftercare only | $10.96 | $15.85 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.47 Typical High $13.80 | Professional | 56 · Pre-op care only | $7.24 | $10.47 | $13.80 |
Where Nebraska sits
The same service costs 3.1 times more in Hawaii 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· 16th of 51
$105
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.