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 $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $7.41 Typical High $18.62 | Professional | None | $7.08 | $7.41 | $18.62 |
Ambetter Setting Professional Modifier None Typical Low $8.51 Median $10.72 Typical High $19.95 | Professional | None | $8.51 | $10.72 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $12.59 Typical High $20.89 | Facility | None | $12.30 | $12.59 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $19.95 Typical High $29.51 | Professional | None | $14.79 | $19.95 | $29.51 |
Medica Setting Facility Modifier None Typical Low $7.59 Median $22.39 Typical High $89.13 | Facility | None | $7.59 | $22.39 | $89.13 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $7.94 Typical High $87.10 | Professional | None | $5.75 | $7.94 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $15.49 Median $19.95 Typical High $30.90 | Professional | None | $15.49 | $19.95 | $30.90 |
Midlands Setting Facility Modifier None Typical Low $12.30 Median $12.59 Typical High $12.59 | Facility | None | $12.30 | $12.59 | $12.59 |
Midlands Setting Professional Modifier None Typical Low $20.42 Median $27.54 Typical High $30.90 | Professional | None | $20.42 | $27.54 | $30.90 |
United Setting Professional Modifier None Typical Low $4.47 Median $7.24 Typical High $12.02 | Professional | None | $4.47 | $7.24 | $12.02 |
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 $3.55 Median $3.55 Typical High $5.50 | Professional | 52 · Reduced service | $3.55 | $3.55 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $2.19 | Professional | 53 · Discontinued | $1.45 | $1.45 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.62 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $1.10 |
Where Nebraska sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 40th of 51
$10.96
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.