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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $257.04 | Professional | None | $181.97 | $194.98 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $338.84 Typical High $338.84 | Facility | None | $218.78 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $645.65 | Professional | None | $331.13 | $380.19 | $645.65 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $338.84 Typical High $1,621.81 | Facility | None | $190.55 | $338.84 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $234.42 | Professional | None | $114.82 | $151.36 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $645.65 | Professional | None | $331.13 | $331.13 | $645.65 |
Midlands Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $831.76 | Professional | None | $416.87 | $645.65 | $831.76 |
United Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $346.74 | Facility | None | $199.53 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $223.87 | Professional | None | $109.65 | $151.36 | $223.87 |
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 $91.20 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $91.20 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $51.29 | Professional | 53 · Discontinued | $36.31 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $29.51 Typical High $38.90 | Professional | 55 · Aftercare only | $26.92 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $18.20 | $19.50 | $25.70 |
Where Nebraska sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 25th of 51
$195
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.