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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Professional | None | $436.52 | $436.52 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $758.58 Typical High $758.58 | Facility | None | $416.87 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,445.44 | Professional | None | $741.31 | $794.33 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $741.31 Typical High $3,162.28 | Facility | None | $426.58 | $741.31 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $562.34 | Professional | None | $234.42 | $338.84 | $562.34 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,445.44 | Professional | None | $741.31 | $741.31 | $1,445.44 |
Midlands Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $1,862.09 | Professional | None | $933.25 | $1,445.44 | $1,862.09 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
United Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $457.09 | Professional | None | $245.47 | $338.84 | $457.09 |
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 $181.97 Median $218.78 Typical High $288.40 | Professional | 52 · Reduced service | $181.97 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $87.10 Typical High $114.82 | Professional | 53 · Discontinued | $72.44 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $66.07 Typical High $87.10 | Professional | 55 · Aftercare only | $54.95 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $57.54 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $57.54 |
Where Nebraska sits
The same service costs 2.2 times more in Montana 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· 20th of 51
$513
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.