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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $478.63 | Professional | None | $302.00 | $363.08 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $1,445.44 Typical High $1,445.44 | Professional | None | $501.19 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $630.96 Typical High $630.96 | Facility | None | $316.23 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,202.26 | Professional | None | $616.60 | $660.69 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $616.60 Typical High $2,630.27 | Facility | None | $354.81 | $616.60 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $467.74 | Professional | None | $194.98 | $281.84 | $467.74 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,202.26 | Professional | None | $616.60 | $616.60 | $1,202.26 |
Midlands Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,548.82 | Professional | None | $776.25 | $1,202.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $380.19 | Professional | None | $204.17 | $281.84 | $380.19 |
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 $151.36 Median $181.97 Typical High $239.88 | Professional | 52 · Reduced service | $151.36 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $72.44 Typical High $97.72 | Professional | 53 · Discontinued | $60.26 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $54.95 Typical High $72.44 | Professional | 55 · Aftercare only | $45.71 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $36.31 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.20 | $36.31 | $47.86 |
Where Nebraska sits
The same service costs 2.6 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· 21st of 51
$363
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.