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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $134.90 | Professional | None | $93.33 | $102.33 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $173.78 Typical High $173.78 | Facility | None | $89.13 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $331.13 | Professional | None | $173.78 | $181.97 | $331.13 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $741.31 | Facility | None | $100.00 | $169.82 | $741.31 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $151.36 | Professional | None | $53.70 | $77.62 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $331.13 | Professional | None | $173.78 | $173.78 | $331.13 |
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 $218.78 Median $331.13 Typical High $426.58 | Professional | None | $218.78 | $331.13 | $426.58 |
United Setting Facility Modifier None Typical Low $77.62 Median $162.18 Typical High $162.18 | Facility | None | $77.62 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $104.71 | Professional | None | $56.23 | $77.62 | $104.71 |
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 $51.29 Typical High $67.61 | Professional | 52 · Reduced service | $42.66 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $20.42 Typical High $26.92 | Professional | 53 · Discontinued | $16.98 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.14 Typical High $20.42 | Professional | 55 · Aftercare only | $12.59 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.23 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.51 | $10.23 | $13.49 |
Where Nebraska sits
The same service costs 2.8 times more in Kansas than in Delaware. 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· 19th of 51
$120
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.