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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $467.74 | Professional | None | $154.88 | $177.83 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $302.00 | Professional | None | $109.65 | $208.93 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $309.03 Typical High $309.03 | Facility | None | $141.25 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $575.44 | Professional | None | $302.00 | $316.23 | $575.44 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $302.00 Typical High $1,288.25 | Facility | None | $173.78 | $302.00 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $245.47 | Professional | None | $102.33 | $134.90 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $575.44 | Professional | None | $302.00 | $302.00 | $575.44 |
Midlands Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $741.31 | Professional | None | $380.19 | $575.44 | $741.31 |
Oscar Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Facility | None | $1,148.15 | $1,148.15 | $1,348.96 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $190.55 | Professional | None | $97.72 | $134.90 | $190.55 |
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 $75.86 Median $89.13 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $46.77 | Professional | 53 · Discontinued | $30.90 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.30 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.49 | $17.78 | $23.44 |
Where Nebraska sits
The same service costs 2.2 times more in Hawaii 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· 17th of 51
$209
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.