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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $524.81 | Professional | None | $199.53 | $199.53 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $457.09 | Facility | None | $302.00 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $1,047.13 | Professional | None | $354.81 | $446.68 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $389.05 Typical High $1,348.96 | Facility | None | $229.09 | $389.05 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $389.05 | Professional | None | $162.18 | $245.47 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $1,047.13 | Professional | None | $446.68 | $457.09 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,096.48 | Professional | None | $602.56 | $1,000.00 | $1,096.48 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
United Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $346.74 | Professional | None | $128.82 | $245.47 | $346.74 |
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 $100.00 Median $100.00 Typical High $131.83 | Professional | 52 · Reduced service | $100.00 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | 53 · Discontinued | $39.81 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $39.81 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $26.30 |
Where Nebraska sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$309
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.