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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $56.23 | Professional | None | $35.48 | $42.66 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $74.13 Typical High $74.13 | Facility | None | $37.15 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $138.04 | Professional | None | $72.44 | $75.86 | $138.04 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $72.44 Typical High $309.03 | Facility | None | $41.69 | $72.44 | $309.03 |
Medica Setting Professional Modifier None Typical Low $22.39 Median $32.36 Typical High $51.29 | Professional | None | $22.39 | $32.36 | $51.29 |
Midlands Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $138.04 | Professional | None | $72.44 | $72.44 | $138.04 |
Midlands Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $177.83 | Professional | None | $91.20 | $138.04 | $177.83 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $44.67 | Professional | None | $23.44 | $32.36 | $44.67 |
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 $17.78 Median $21.38 Typical High $28.18 | Professional | 52 · Reduced service | $17.78 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.51 Typical High $11.22 | Professional | 53 · Discontinued | $7.08 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.46 Typical High $8.51 | Professional | 55 · Aftercare only | $5.25 | $6.46 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.27 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.55 | $4.27 | $5.62 |
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· 20th of 51
$42.66
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.