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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $114.82 | Professional | None | $39.81 | $43.65 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $51.29 Typical High $100.00 | Professional | None | $19.95 | $51.29 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $75.86 Typical High $75.86 | Facility | None | $45.71 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $141.25 | Professional | None | $74.13 | $83.18 | $141.25 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $74.13 Typical High $354.81 | Facility | None | $28.18 | $74.13 | $354.81 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $75.86 | Professional | None | $25.70 | $33.11 | $75.86 |
Midlands Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $141.25 | Professional | None | $74.13 | $74.13 | $141.25 |
Midlands Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $186.21 | Professional | None | $93.33 | $141.25 | $186.21 |
Oscar Health Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $275.42 | Facility | None | $239.88 | $239.88 | $275.42 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $144.54 | Professional | None | $74.13 | $107.15 | $144.54 |
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 $24.55 Median $33.11 Typical High $50.12 | Professional | None | $24.55 | $33.11 | $50.12 |
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 $19.95 Median $21.88 Typical High $28.84 | Professional | 52 · Reduced service | $19.95 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.71 Typical High $11.48 | Professional | 53 · Discontinued | $7.94 | $8.71 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.61 Typical High $8.71 | Professional | 55 · Aftercare only | $5.89 | $6.61 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.37 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.98 | $4.37 | $5.75 |
Where Nebraska sits
The same service costs 3.8 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· 21st of 51
$51.29
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.