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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,348.96 | $1,778.28 |
Ambetter Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,318.26 | $2,344.23 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,570.40 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $11,220.18 | Facility | None | $1,318.26 | $2,290.87 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,621.81 | Professional | None | $794.33 | $1,047.13 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,290.87 | $4,466.84 |
Midlands Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $2,884.03 Median $4,466.84 Typical High $5,754.40 | Professional | None | $2,884.03 | $4,466.84 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,398.83 Typical High $2,398.83 | Facility | None | $1,122.02 | $2,398.83 | $2,398.83 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,584.89 | Professional | None | $758.58 | $1,047.13 | $1,584.89 |
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 $630.96 Median $676.08 Typical High $891.25 | Professional | 52 · Reduced service | $630.96 | $676.08 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $363.08 | Professional | 53 · Discontinued | $251.19 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $269.15 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $134.90 Typical High $177.83 | Professional | 56 · Pre-op care only | $125.89 | $134.90 | $177.83 |
Where Nebraska sits
The same service costs 2.9 times more in Hawaii 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
$1,585
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.