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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $67.61 | Professional | None | $40.74 | $51.29 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $87.10 Typical High $87.10 | Facility | None | $36.31 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $165.96 | Professional | None | $87.10 | $95.50 | $165.96 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $85.11 Typical High $354.81 | Facility | None | $50.12 | $85.11 | $354.81 |
Medica Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $61.66 | Professional | None | $26.30 | $38.90 | $61.66 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $165.96 | Professional | None | $87.10 | $87.10 | $165.96 |
Midlands Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $213.80 | Professional | None | $109.65 | $165.96 | $213.80 |
United Setting Facility Modifier None Typical Low $38.90 Median $77.62 Typical High $77.62 | Facility | None | $38.90 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $50.12 | Professional | None | $28.18 | $37.15 | $50.12 |
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 $20.42 Median $25.70 Typical High $33.88 | Professional | 52 · Reduced service | $20.42 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.23 Typical High $13.49 | Professional | 53 · Discontinued | $8.13 | $10.23 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.59 Typical High $10.23 | Professional | 55 · Aftercare only | $6.03 | $7.59 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.13 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.07 | $5.13 | $6.76 |
Where Nebraska sits
The same service costs 2.9 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· 19th of 51
$51.29
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.