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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $257.04 | Professional | None | $87.10 | $97.72 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $114.82 | Professional | None | $79.43 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $165.96 Typical High $165.96 | Facility | None | $97.72 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $316.23 | Professional | None | $162.18 | $186.21 | $316.23 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $165.96 Typical High $758.58 | Facility | None | $95.50 | $165.96 | $758.58 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $158.49 | Professional | None | $56.23 | $74.13 | $158.49 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $316.23 | Professional | None | $162.18 | $162.18 | $316.23 |
Midlands Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $407.38 | Professional | None | $208.93 | $316.23 | $407.38 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $323.59 | Professional | None | $165.96 | $229.09 | $323.59 |
United Setting Facility Modifier None Typical Low $79.43 Median $169.82 Typical High $169.82 | Facility | None | $79.43 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $109.65 | Professional | None | $53.70 | $74.13 | $109.65 |
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 $43.65 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.50 Typical High $25.70 | Professional | 53 · Discontinued | $17.38 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.45 Typical High $19.50 | Professional | 55 · Aftercare only | $13.18 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $9.77 | $12.88 |
Where Nebraska sits
The same service costs 2.8 times more in Hawaii than in Florida. 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
$115
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.