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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $162.18 | Professional | None | $58.88 | $61.66 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $72.44 Typical High $114.82 | Professional | None | $45.71 | $72.44 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $107.15 Typical High $107.15 | Facility | None | $57.54 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $199.53 | Professional | None | $104.71 | $104.71 | $199.53 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $104.71 Typical High $467.74 | Facility | None | $60.26 | $104.71 | $467.74 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $100.00 | Professional | None | $34.67 | $47.86 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $199.53 | Professional | None | $104.71 | $104.71 | $199.53 |
Midlands Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $263.03 | Professional | None | $131.83 | $199.53 | $263.03 |
United Setting Facility Modifier None Typical Low $43.65 Median $104.71 Typical High $104.71 | Facility | None | $43.65 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $67.61 | Professional | None | $34.67 | $47.86 | $67.61 |
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 $27.54 Median $30.90 Typical High $40.74 | Professional | 52 · Reduced service | $27.54 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.30 Typical High $16.22 | Professional | 53 · Discontinued | $11.22 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.33 Typical High $12.30 | Professional | 55 · Aftercare only | $8.32 | $9.33 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.17 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.62 | $6.17 | $8.13 |
Where Nebraska sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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· 18th of 51
$72.44
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.