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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $24.55 Typical High $33.11 | Professional | None | $20.42 | $24.55 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $42.66 Typical High $42.66 | Facility | None | $25.70 | $42.66 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $81.28 | Professional | None | $41.69 | $44.67 | $81.28 |
Medica Setting Facility Modifier None Typical Low $24.55 Median $41.69 Typical High $177.83 | Facility | None | $24.55 | $41.69 | $177.83 |
Medica Setting Professional Modifier None Typical Low $13.18 Median $19.05 Typical High $29.51 | Professional | None | $13.18 | $19.05 | $29.51 |
Midlands Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $81.28 | Professional | None | $41.69 | $41.69 | $81.28 |
Midlands Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Midlands Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $104.71 | Professional | None | $52.48 | $81.28 | $104.71 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $13.80 Median $19.05 Typical High $25.70 | Professional | None | $13.80 | $19.05 | $25.70 |
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 $10.23 Median $12.30 Typical High $16.22 | Professional | 52 · Reduced service | $10.23 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.90 Typical High $6.61 | Professional | 53 · Discontinued | $4.07 | $4.90 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.72 Typical High $4.90 | Professional | 55 · Aftercare only | $3.09 | $3.72 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.45 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.04 | $2.45 | $3.31 |
Where Nebraska sits
The same service costs 2.2 times more in Montana than in New Jersey. 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· 24th of 51
$24.55
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.