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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $75.86 | Professional | None | $52.48 | $56.23 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $97.72 Typical High $97.72 | Facility | None | $64.57 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $186.21 | Professional | None | $95.50 | $109.65 | $186.21 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $97.72 Typical High $467.74 | Facility | None | $56.23 | $97.72 | $467.74 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $67.61 | Professional | None | $33.11 | $43.65 | $67.61 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $186.21 | Professional | None | $95.50 | $95.50 | $186.21 |
Midlands Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $239.88 | Professional | None | $120.23 | $186.21 | $239.88 |
United Setting Facility Modifier None Typical Low $57.54 Median $100.00 Typical High $100.00 | Facility | None | $57.54 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $66.07 | Professional | None | $31.62 | $43.65 | $66.07 |
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 $26.30 Median $28.18 Typical High $37.15 | Professional | 52 · Reduced service | $26.30 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.22 Typical High $15.14 | Professional | 53 · Discontinued | $10.47 | $11.22 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.51 Typical High $11.22 | Professional | 55 · Aftercare only | $7.94 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.62 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.25 | $5.62 | $7.59 |
Where Nebraska sits
The same service costs 3.5 times more in Hawaii than in New Jersey. 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· 26th of 51
$57.54
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.