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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $45.71 | Professional | None | $34.67 | $34.67 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $60.26 Typical High $60.26 | Facility | None | $38.90 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $114.82 | Professional | None | $58.88 | $67.61 | $114.82 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $60.26 Typical High $295.12 | Facility | None | $33.88 | $60.26 | $295.12 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $26.92 Typical High $44.67 | Professional | None | $20.42 | $26.92 | $44.67 |
Midlands Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $114.82 | Professional | None | $58.88 | $58.88 | $114.82 |
Midlands Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Midlands Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $147.91 | Professional | None | $74.13 | $114.82 | $147.91 |
United Setting Facility Modifier None Typical Low $35.48 Median $61.66 Typical High $61.66 | Facility | None | $35.48 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $19.50 Median $26.92 Typical High $39.81 | Professional | None | $19.50 | $26.92 | $39.81 |
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 $16.60 Median $17.38 Typical High $22.91 | Professional | 52 · Reduced service | $16.60 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.92 Typical High $9.12 | Professional | 53 · Discontinued | $6.61 | $6.92 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.25 Typical High $6.92 | Professional | 55 · Aftercare only | $5.01 | $5.25 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.47 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.31 | $3.47 | $4.57 |
Where Nebraska sits
The same service costs 4.7 times more in Hawaii than in Florida. 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
$40.74
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.