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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | None | $125.89 | $125.89 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $218.78 Typical High $218.78 | Facility | None | $128.82 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $407.38 | Professional | None | $213.80 | $223.87 | $407.38 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $912.01 | Facility | None | $123.03 | $213.80 | $912.01 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $162.18 | Professional | None | $66.07 | $97.72 | $162.18 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $407.38 | Professional | None | $213.80 | $213.80 | $407.38 |
Midlands Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $537.03 | Professional | None | $269.15 | $407.38 | $537.03 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
United Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $131.83 | Professional | None | $70.79 | $95.50 | $131.83 |
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 $52.48 Median $63.10 Typical High $83.18 | Professional | 52 · Reduced service | $52.48 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.12 Typical High $33.11 | Professional | 53 · Discontinued | $20.89 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.05 Typical High $25.12 | Professional | 55 · Aftercare only | $15.49 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.47 | $12.59 | $16.60 |
Where Nebraska sits
The same service costs 2.5 times more in Kansas than in Utah. 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
$148
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.