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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $53.70 | Professional | None | $37.15 | $40.74 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $69.18 Typical High $69.18 | Facility | None | $40.74 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $131.83 | Professional | None | $67.61 | $72.44 | $131.83 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $67.61 Typical High $323.59 | Facility | None | $39.81 | $67.61 | $323.59 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $30.90 Typical High $51.29 | Professional | None | $23.99 | $30.90 | $51.29 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $131.83 | Professional | None | $67.61 | $67.61 | $131.83 |
Midlands Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $169.82 | Professional | None | $87.10 | $131.83 | $169.82 |
United Setting Facility Modifier None Typical Low $36.31 Median $72.44 Typical High $72.44 | Facility | None | $36.31 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $22.39 Median $30.90 Typical High $46.77 | Professional | None | $22.39 | $30.90 | $46.77 |
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 $18.62 Median $20.42 Typical High $26.92 | Professional | 52 · Reduced service | $18.62 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.13 Typical High $10.72 | Professional | 53 · Discontinued | $7.41 | $8.13 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.03 Typical High $7.94 | Professional | 55 · Aftercare only | $5.62 | $6.03 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.07 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.72 | $4.07 | $5.37 |
Where Nebraska sits
The same service costs 2.7 times more in Montana 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· 24th of 51
$40.74
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.