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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $309.03 | Professional | None | $173.78 | $234.42 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $407.38 Typical High $407.38 | Facility | None | $223.87 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $776.25 | Professional | None | $398.11 | $426.58 | $776.25 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,548.82 | Facility | None | $229.09 | $398.11 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $281.84 | Professional | None | $120.23 | $181.97 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $776.25 | Professional | None | $398.11 | $398.11 | $776.25 |
Midlands Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,000.00 | Professional | None | $501.19 | $776.25 | $1,000.00 |
United Setting Facility Modifier None Typical Low $190.55 Median $331.13 Typical High $331.13 | Facility | None | $190.55 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $213.80 | Professional | None | $120.23 | $169.82 | $213.80 |
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 $87.10 Median $117.49 Typical High $154.88 | Professional | 52 · Reduced service | $87.10 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $46.77 Typical High $61.66 | Professional | 53 · Discontinued | $34.67 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $25.70 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.44 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.38 | $23.44 | $30.90 |
Where Nebraska sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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
$234
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.