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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | None | $100.00 | $100.00 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $173.78 Typical High $173.78 | Facility | None | $97.72 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $323.59 | Professional | None | $169.82 | $190.55 | $323.59 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $169.82 Typical High $812.83 | Facility | None | $97.72 | $169.82 | $812.83 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $128.82 | Professional | None | $57.54 | $75.86 | $128.82 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $323.59 | Professional | None | $169.82 | $169.82 | $323.59 |
Midlands Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $416.87 | Professional | None | $213.80 | $323.59 | $416.87 |
United Setting Facility Modifier None Typical Low $95.50 Median $173.78 Typical High $173.78 | Facility | None | $95.50 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $112.20 | Professional | None | $54.95 | $75.86 | $112.20 |
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 $45.71 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $45.71 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.95 Typical High $26.30 | Professional | 53 · Discontinued | $18.20 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.79 Typical High $19.95 | Professional | 55 · Aftercare only | $13.49 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $13.18 |
Where Nebraska sits
The same service costs 3.2 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
$100
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.