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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $79.43 | Professional | None | $48.98 | $58.88 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $102.33 Typical High $102.33 | Facility | None | $51.29 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $194.98 | Professional | None | $100.00 | $107.15 | $194.98 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $100.00 Typical High $426.58 | Facility | None | $58.88 | $100.00 | $426.58 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $70.79 | Professional | None | $31.62 | $45.71 | $70.79 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $194.98 | Professional | None | $100.00 | $100.00 | $194.98 |
Midlands Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Midlands Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $251.19 | Professional | None | $125.89 | $194.98 | $251.19 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $61.66 | Professional | None | $33.11 | $45.71 | $61.66 |
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 $24.55 Median $29.51 Typical High $38.90 | Professional | 52 · Reduced service | $24.55 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.02 Typical High $15.85 | Professional | 53 · Discontinued | $9.77 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.91 Typical High $11.75 | Professional | 55 · Aftercare only | $7.41 | $8.91 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.89 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.90 | $5.89 | $7.94 |
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
$58.88
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.