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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $162.18 | Professional | None | $91.20 | $100.00 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $173.78 Typical High $173.78 | Facility | None | $87.10 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $323.59 | Professional | None | $169.82 | $181.97 | $323.59 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $169.82 Typical High $707.95 | Facility | None | $97.72 | $169.82 | $707.95 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $120.23 | Professional | None | $52.48 | $75.86 | $120.23 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $323.59 | Professional | None | $169.82 | $169.82 | $323.59 |
Midlands Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $426.58 | Professional | None | $213.80 | $323.59 | $426.58 |
United Setting Facility Modifier None Typical Low $39.81 Median $158.49 Typical High $158.49 | Facility | None | $39.81 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $104.71 | Professional | None | $56.23 | $75.86 | $104.71 |
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 $42.66 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $42.66 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.95 Typical High $26.30 | Professional | 53 · Discontinued | $16.98 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $12.88 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.51 | $10.00 | $13.18 |
Where Nebraska sits
The same service costs 2.5 times more in Arkansas than in Florida. 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· 20th of 51
$100
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.