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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $151.36 | Professional | None | $57.54 | $57.54 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $100.00 | Facility | None | $56.23 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $186.21 | Professional | None | $97.72 | $102.33 | $186.21 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $97.72 Typical High $416.87 | Facility | None | $56.23 | $97.72 | $416.87 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $69.18 | Professional | None | $30.20 | $43.65 | $69.18 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $186.21 | Professional | None | $97.72 | $97.72 | $186.21 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $239.88 | Professional | None | $123.03 | $186.21 | $239.88 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $60.26 | Professional | None | $31.62 | $43.65 | $60.26 |
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 $23.99 Median $28.84 Typical High $38.02 | Professional | 52 · Reduced service | $23.99 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.48 Typical High $15.14 | Professional | 53 · Discontinued | $9.55 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.71 Typical High $11.48 | Professional | 55 · Aftercare only | $7.08 | $8.71 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.75 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $5.75 | $7.59 |
Where Nebraska sits
The same service costs 3.1 times more in Hawaii 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· 19th of 51
$57.54
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.