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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.94 | Professional | None | $6.03 | $6.03 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $10.47 Typical High $13.18 | Professional | None | $6.76 | $10.47 | $13.18 |
Medica Setting Facility Modifier None Typical Low $4.57 Median $28.84 Typical High $89.13 | Facility | None | $4.57 | $28.84 | $89.13 |
Medica Setting Professional Modifier None Typical Low $3.63 Median $5.50 Typical High $9.12 | Professional | None | $3.63 | $5.50 | $9.12 |
Midlands Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $3.63 Median $5.50 Typical High $9.12 | Professional | None | $3.63 | $5.50 | $9.12 |
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 $3.02 Median $3.02 Typical High $3.98 | Professional | 52 · Reduced service | $3.02 | $3.02 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $1.58 | Professional | 53 · Discontinued | $1.23 | $1.23 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $1.20 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.79 |
Where Nebraska sits
The same service costs 39.8 times more in New York than in Hawaii. 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· 50th of 51
$5.50
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.