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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $147.91 | Professional | None | $93.33 | $112.20 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $194.98 Typical High $194.98 | Facility | None | $117.49 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $363.08 | Professional | None | $190.55 | $199.53 | $363.08 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $186.21 Typical High $812.83 | Facility | None | $109.65 | $186.21 | $812.83 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $134.90 | Professional | None | $58.88 | $85.11 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $363.08 | Professional | None | $190.55 | $190.55 | $363.08 |
Midlands Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $467.74 | Professional | None | $239.88 | $363.08 | $467.74 |
United Setting Facility Modifier None Typical Low $57.54 Median $177.83 Typical High $177.83 | Facility | None | $57.54 | $177.83 | $177.83 |
United Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $114.82 | Professional | None | $61.66 | $85.11 | $114.82 |
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 $46.77 Median $56.23 Typical High $74.13 | Professional | 52 · Reduced service | $46.77 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.39 Typical High $29.51 | Professional | 53 · Discontinued | $18.62 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.60 Typical High $22.39 | Professional | 55 · Aftercare only | $13.80 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.22 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.33 | $11.22 | $14.79 |
Where Nebraska sits
The same service costs 2.1 times more in Montana 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· 22nd of 51
$112
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.