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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $354.81 | Professional | None | $134.90 | $134.90 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $234.42 Typical High $234.42 | Facility | None | $141.25 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $446.68 | Professional | None | $229.09 | $245.47 | $446.68 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $229.09 Typical High $977.24 | Facility | None | $131.83 | $229.09 | $977.24 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $186.21 | Professional | None | $72.44 | $104.71 | $186.21 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $446.68 | Professional | None | $229.09 | $229.09 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $575.44 | Professional | None | $288.40 | $446.68 | $575.44 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $141.25 | Professional | None | $75.86 | $104.71 | $141.25 |
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 $56.23 Median $67.61 Typical High $89.13 | Professional | 52 · Reduced service | $56.23 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.92 Typical High $36.31 | Professional | 53 · Discontinued | $22.39 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $26.92 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $17.78 |
Where Nebraska sits
The same service costs 2.0 times more in Wyoming than in New Jersey. 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· 23rd of 51
$135
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.