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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $151.36 | Professional | None | $102.33 | $114.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $199.53 Typical High $199.53 | Facility | None | $120.23 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $371.54 | Professional | None | $194.98 | $213.80 | $371.54 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $190.55 Typical High $870.96 | Facility | None | $112.20 | $190.55 | $870.96 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $138.04 | Professional | None | $64.57 | $87.10 | $138.04 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $371.54 | Professional | None | $194.98 | $194.98 | $371.54 |
Midlands Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $478.63 | Professional | None | $245.47 | $371.54 | $478.63 |
United Setting Facility Modifier None Typical Low $72.44 Median $194.98 Typical High $194.98 | Facility | None | $72.44 | $194.98 | $194.98 |
United Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $125.89 | Professional | None | $63.10 | $87.10 | $125.89 |
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 $51.29 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $51.29 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $20.42 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $15.14 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $15.14 |
Where Nebraska sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 24th of 51
$115
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.