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 $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $25.12 | Professional | None | $16.22 | $16.22 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $67.61 | Professional | None | $32.36 | $46.77 | $67.61 |
Medica Setting Facility Modifier None Typical Low $17.78 Median $51.29 Typical High $151.36 | Facility | None | $17.78 | $51.29 | $151.36 |
Medica Setting Professional Modifier None Typical Low $12.59 Median $16.60 Typical High $199.53 | Professional | None | $12.59 | $16.60 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $70.79 | Professional | None | $35.48 | $46.77 | $70.79 |
Midlands Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $72.44 | Professional | None | $46.77 | $63.10 | $72.44 |
United Setting Professional Modifier None Typical Low $10.47 Median $16.60 Typical High $27.54 | Professional | None | $10.47 | $16.60 | $27.54 |
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 $8.13 Median $8.13 Typical High $12.59 | Professional | 52 · Reduced service | $8.13 | $8.13 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $5.01 | Professional | 53 · Discontinued | $3.31 | $3.31 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $3.80 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $2.51 |
Where Nebraska sits
The same service costs 4.1 times more in Wyoming 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· 32nd of 51
$21.38
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.