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 $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $26.92 Typical High $35.48 | Professional | None | $22.39 | $26.92 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $45.71 Typical High $45.71 | Facility | None | $22.91 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $87.10 | Professional | None | $44.67 | $47.86 | $87.10 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $44.67 Typical High $190.55 | Facility | None | $26.30 | $44.67 | $190.55 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $20.42 Typical High $32.36 | Professional | None | $14.13 | $20.42 | $32.36 |
Midlands Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $87.10 | Professional | None | $44.67 | $44.67 | $87.10 |
Midlands Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Midlands Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $112.20 | Professional | None | $57.54 | $87.10 | $112.20 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $14.79 Median $20.42 Typical High $27.54 | Professional | None | $14.79 | $20.42 | $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 $11.22 Median $13.49 Typical High $17.78 | Professional | 52 · Reduced service | $11.22 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $5.37 Typical High $7.08 | Professional | 53 · Discontinued | $4.47 | $5.37 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.98 Typical High $5.37 | Professional | 55 · Aftercare only | $3.31 | $3.98 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.69 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.24 | $2.69 | $3.55 |
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
$26.92
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.