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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $602.56 | Professional | None | $223.87 | $245.47 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $426.58 Typical High $426.58 | Facility | None | $208.93 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $794.33 | Professional | None | $416.87 | $436.52 | $794.33 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $1,778.28 | Facility | None | $239.88 | $416.87 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $295.12 | Professional | None | $128.82 | $186.21 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $794.33 | Professional | None | $416.87 | $416.87 | $794.33 |
Midlands Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,023.29 | Professional | None | $524.81 | $794.33 | $1,023.29 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $251.19 | Professional | None | $134.90 | $186.21 | $251.19 |
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 $102.33 Median $123.03 Typical High $162.18 | Professional | 52 · Reduced service | $102.33 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $48.98 Typical High $64.57 | Professional | 53 · Discontinued | $40.74 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $24.55 Typical High $32.36 | Professional | 56 · Pre-op care only | $20.42 | $24.55 | $32.36 |
Where Nebraska sits
The same service costs 2.4 times more in Hawaii 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· 17th of 51
$251
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.