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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $831.76 | Professional | None | $407.38 | $446.68 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $776.25 Typical High $776.25 | Facility | None | $457.09 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,445.44 | Professional | None | $758.58 | $851.14 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $758.58 Typical High $3,801.89 | Facility | None | $436.52 | $758.58 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $537.03 | Professional | None | $263.03 | $338.84 | $537.03 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,445.44 | Professional | None | $758.58 | $758.58 | $1,445.44 |
Midlands Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,862.09 | Professional | None | $954.99 | $1,445.44 | $1,862.09 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,513.56 | Professional | None | $758.58 | $1,096.48 | $1,513.56 |
United Setting Facility Modifier None Typical Low $407.38 Median $794.33 Typical High $794.33 | Facility | None | $407.38 | $794.33 | $794.33 |
United Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $512.86 | Professional | None | $245.47 | $338.84 | $512.86 |
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 $204.17 Median $223.87 Typical High $295.12 | Professional | 52 · Reduced service | $204.17 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $117.49 | Professional | 53 · Discontinued | $83.18 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $89.13 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $58.88 |
Where Nebraska sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 28th of 51
$457
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.