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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $165.96 | Professional | None | $60.26 | $63.10 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $112.20 | Professional | None | $74.13 | $74.13 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $109.65 Typical High $109.65 | Facility | None | $61.66 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $208.93 | Professional | None | $107.15 | $123.03 | $208.93 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $107.15 Typical High $478.63 | Facility | None | $63.10 | $107.15 | $478.63 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $107.15 | Professional | None | $37.15 | $48.98 | $107.15 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $208.93 | Professional | None | $107.15 | $107.15 | $208.93 |
Midlands Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $269.15 | Professional | None | $134.90 | $208.93 | $269.15 |
United Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $109.65 | Facility | None | $72.44 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $75.86 | Professional | None | $35.48 | $48.98 | $75.86 |
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 $30.20 Median $31.62 Typical High $41.69 | Professional | 52 · Reduced service | $30.20 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $16.98 | Professional | 53 · Discontinued | $12.02 | $12.59 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.55 Typical High $12.59 | Professional | 55 · Aftercare only | $8.91 | $9.55 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $8.51 |
Where Nebraska sits
The same service costs 2.1 times more in Wisconsin 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· 21st of 51
$74.13
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.