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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $154.88 | Professional | None | $85.11 | $117.49 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $199.53 Typical High $199.53 | Facility | None | $102.33 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $380.19 | Professional | None | $181.97 | $194.98 | $380.19 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $194.98 Typical High $741.31 | Facility | None | $114.82 | $194.98 | $741.31 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $173.78 | Professional | None | $60.26 | $89.13 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $380.19 | Professional | None | $194.98 | $194.98 | $380.19 |
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 $251.19 Median $380.19 Typical High $489.78 | Professional | None | $251.19 | $380.19 | $489.78 |
United Setting Facility Modifier None Typical Low $87.10 Median $162.18 Typical High $162.18 | Facility | None | $87.10 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $109.65 | Professional | None | $60.26 | $85.11 | $109.65 |
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 $42.66 Median $58.88 Typical High $77.62 | Professional | 52 · Reduced service | $42.66 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $23.44 Typical High $30.90 | Professional | 53 · Discontinued | $16.98 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $12.59 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.75 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.51 | $11.75 | $15.49 |
Where Nebraska sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 14th of 51
$138
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.