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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $380.19 | Professional | None | $141.25 | $154.88 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $181.97 | Professional | None | $120.23 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $269.15 Typical High $269.15 | Facility | None | $151.36 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $501.19 | Professional | None | $263.03 | $275.42 | $501.19 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $263.03 Typical High $1,122.02 | Facility | None | $151.36 | $263.03 | $1,122.02 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $234.42 | Professional | None | $81.28 | $117.49 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $501.19 | Professional | None | $263.03 | $263.03 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $645.65 | Professional | None | $331.13 | $501.19 | $645.65 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $158.49 | Professional | None | $85.11 | $117.49 | $158.49 |
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 $64.57 Median $77.62 Typical High $102.33 | Professional | 52 · Reduced service | $64.57 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.90 Typical High $40.74 | Professional | 53 · Discontinued | $25.70 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.44 Typical High $30.90 | Professional | 55 · Aftercare only | $19.05 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.49 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $15.49 | $20.42 |
Where Nebraska sits
The same service costs 2.1 times more in Hawaii 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· 16th of 51
$182
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.