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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $41.69 | Professional | None | $26.30 | $31.62 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $54.95 Typical High $54.95 | Facility | None | $27.54 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $57.54 Typical High $104.71 | Professional | None | $53.70 | $57.54 | $104.71 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $53.70 Typical High $229.09 | Facility | None | $30.90 | $53.70 | $229.09 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $24.55 Typical High $38.02 | Professional | None | $16.98 | $24.55 | $38.02 |
Midlands Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $104.71 | Professional | None | $53.70 | $53.70 | $104.71 |
Midlands Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $134.90 | Professional | None | $67.61 | $104.71 | $134.90 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $17.78 Median $23.99 Typical High $33.11 | Professional | None | $17.78 | $23.99 | $33.11 |
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 $13.18 Median $15.85 Typical High $20.89 | Professional | 52 · Reduced service | $13.18 | $15.85 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.31 Typical High $8.32 | Professional | 53 · Discontinued | $5.25 | $6.31 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.79 Typical High $6.31 | Professional | 55 · Aftercare only | $3.98 | $4.79 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.16 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.63 | $3.16 | $4.17 |
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
$31.62
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.