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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | None | $144.54 | $144.54 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $323.59 | Facility | None | $213.80 | $323.59 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $707.95 | Professional | None | $257.04 | $323.59 | $707.95 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $275.42 Typical High $1,096.48 | Facility | None | $162.18 | $275.42 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $263.03 | Professional | None | $112.20 | $165.96 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $707.95 | Professional | None | $323.59 | $323.59 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $794.33 | Professional | None | $436.52 | $707.95 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $478.63 | Professional | None | $229.09 | $316.23 | $478.63 |
United Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $346.74 | Facility | None | $213.80 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $245.47 | Professional | None | $91.20 | $165.96 | $245.47 |
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 $72.44 Median $72.44 Typical High $97.72 | Professional | 52 · Reduced service | $72.44 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | 53 · Discontinued | $28.84 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $29.51 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $19.50 |
Where Nebraska sits
The same service costs 2.9 times more in Hawaii than in Utah. 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
$214
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.