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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $537.03 | Professional | None | $407.38 | $407.38 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $707.95 | Facility | None | $524.81 | $707.95 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,318.26 | Professional | None | $691.83 | $776.25 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $691.83 Typical High $3,388.44 | Facility | None | $398.11 | $691.83 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $616.60 | Professional | None | $239.88 | $309.03 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,318.26 | Professional | None | $691.83 | $691.83 | $1,318.26 |
Midlands Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,698.24 | Professional | None | $870.96 | $1,318.26 | $1,698.24 |
United Setting Facility Modifier None Typical Low $389.05 Median $724.44 Typical High $724.44 | Facility | None | $389.05 | $724.44 | $724.44 |
United Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $467.74 | Professional | None | $223.87 | $309.03 | $467.74 |
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 $186.21 Median $204.17 Typical High $269.15 | Professional | 52 · Reduced service | $186.21 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $81.28 Typical High $107.15 | Professional | 53 · Discontinued | $75.86 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $81.28 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $53.70 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $53.70 |
Where Nebraska sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 23rd of 51
$479
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.