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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $120.23 | Professional | None | $83.18 | $91.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $154.88 Typical High $154.88 | Facility | None | $91.20 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $295.12 | Professional | None | $151.36 | $162.18 | $295.12 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $154.88 Typical High $707.95 | Facility | None | $89.13 | $154.88 | $707.95 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $109.65 | Professional | None | $53.70 | $69.18 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $295.12 | Professional | None | $151.36 | $151.36 | $295.12 |
Midlands Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $380.19 | Professional | None | $194.98 | $295.12 | $380.19 |
United Setting Facility Modifier None Typical Low $39.81 Median $162.18 Typical High $162.18 | Facility | None | $39.81 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $104.71 | Professional | None | $50.12 | $69.18 | $104.71 |
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 $41.69 Median $45.71 Typical High $60.26 | Professional | 52 · Reduced service | $41.69 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $23.99 | Professional | 53 · Discontinued | $16.60 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.49 Typical High $18.20 | Professional | 55 · Aftercare only | $12.59 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $12.02 |
Where Nebraska sits
The same service costs 2.5 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· 20th of 51
$91.20
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.