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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $75.86 | Professional | None | $43.65 | $50.12 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $87.10 Typical High $87.10 | Facility | None | $46.77 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $165.96 | Professional | None | $85.11 | $91.20 | $165.96 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $85.11 Typical High $354.81 | Facility | None | $48.98 | $85.11 | $354.81 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $64.57 | Professional | None | $25.70 | $38.90 | $64.57 |
Midlands Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $165.96 | Professional | None | $85.11 | $85.11 | $165.96 |
Midlands Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $213.80 | Professional | None | $107.15 | $165.96 | $213.80 |
United Setting Facility Modifier None Typical Low $43.65 Median $75.86 Typical High $75.86 | Facility | None | $43.65 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $27.54 Median $37.15 Typical High $48.98 | Professional | None | $27.54 | $37.15 | $48.98 |
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 $19.50 Median $25.12 Typical High $33.11 | Professional | 52 · Reduced service | $19.50 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $10.00 Typical High $13.49 | Professional | 53 · Discontinued | $7.76 | $10.00 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.59 Typical High $10.00 | Professional | 55 · Aftercare only | $5.89 | $7.59 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.01 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.89 | $5.01 | $6.61 |
Where Nebraska sits
The same service costs 3.1 times more in Hawaii than in Florida. 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
$50.12
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.