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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $645.65 | Professional | None | $257.04 | $257.04 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $446.68 Typical High $446.68 | Facility | None | $245.47 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $831.76 | Professional | None | $436.52 | $489.78 | $831.76 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $436.52 Typical High $2,089.30 | Facility | None | $251.19 | $436.52 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $331.13 | Professional | None | $151.36 | $194.98 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $831.76 | Professional | None | $436.52 | $436.52 | $831.76 |
Midlands Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,071.52 | Professional | None | $549.54 | $831.76 | $1,071.52 |
United Setting Facility Modifier None Typical Low $147.91 Median $457.09 Typical High $457.09 | Facility | None | $147.91 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $295.12 | Professional | None | $141.25 | $194.98 | $295.12 |
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 $117.49 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $117.49 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $67.61 | Professional | 53 · Discontinued | $46.77 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.02 Typical High $51.29 | Professional | 55 · Aftercare only | $35.48 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.70 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.44 | $25.70 | $33.88 |
Where Nebraska sits
The same service costs 2.9 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· 22nd of 51
$257
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.