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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $48.98 | Professional | None | $33.11 | $36.31 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $63.10 Typical High $63.10 | Facility | None | $33.11 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $120.23 | Professional | None | $61.66 | $66.07 | $120.23 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $61.66 Typical High $263.03 | Facility | None | $36.31 | $61.66 | $263.03 |
Medica Setting Professional Modifier None Typical Low $19.50 Median $28.18 Typical High $44.67 | Professional | None | $19.50 | $28.18 | $44.67 |
Midlands Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $120.23 | Professional | None | $61.66 | $61.66 | $120.23 |
Midlands Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Midlands Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $154.88 | Professional | None | $77.62 | $120.23 | $154.88 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $20.42 Median $28.18 Typical High $38.02 | Professional | None | $20.42 | $28.18 | $38.02 |
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 $15.14 Median $18.20 Typical High $24.55 | Professional | 52 · Reduced service | $15.14 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $7.41 Typical High $9.77 | Professional | 53 · Discontinued | $6.03 | $7.41 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.50 Typical High $7.24 | Professional | 55 · Aftercare only | $4.57 | $5.50 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.63 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.02 | $3.63 | $4.79 |
Where Nebraska sits
The same service costs 2.6 times more in Montana than in Kansas. 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· 20th of 51
$36.31
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.