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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $51.29 | Professional | None | $32.36 | $38.90 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $66.07 Typical High $66.07 | Facility | None | $33.11 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $125.89 | Professional | None | $64.57 | $69.18 | $125.89 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $64.57 Typical High $275.42 | Facility | None | $38.02 | $64.57 | $275.42 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $29.51 Typical High $46.77 | Professional | None | $20.42 | $29.51 | $46.77 |
Midlands Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $125.89 | Professional | None | $64.57 | $64.57 | $125.89 |
Midlands Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Midlands Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $162.18 | Professional | None | $83.18 | $125.89 | $162.18 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $21.38 Median $29.51 Typical High $39.81 | Professional | None | $21.38 | $29.51 | $39.81 |
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 $15.85 Median $19.50 Typical High $25.70 | Professional | 52 · Reduced service | $15.85 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.76 Typical High $10.23 | Professional | 53 · Discontinued | $6.46 | $7.76 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.75 Typical High $7.59 | Professional | 55 · Aftercare only | $4.79 | $5.75 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.89 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.24 | $3.89 | $5.13 |
Where Nebraska sits
The same service costs 2.6 times more in Montana than in Delaware. 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
$38.90
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.