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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $275.42 | Professional | None | $181.97 | $208.93 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $363.08 | Facility | None | $186.21 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $676.08 | Professional | None | $346.74 | $354.81 | $676.08 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $354.81 Typical High $1,584.89 | Facility | None | $204.17 | $354.81 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $251.19 | Professional | None | $114.82 | $162.18 | $251.19 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $676.08 | Professional | None | $354.81 | $354.81 | $676.08 |
Midlands Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $891.25 | Professional | None | $446.68 | $676.08 | $891.25 |
United Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $346.74 | Facility | None | $199.53 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $223.87 | Professional | None | $117.49 | $162.18 | $223.87 |
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 $91.20 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $91.20 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $36.31 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $31.62 Typical High $41.69 | Professional | 55 · Aftercare only | $26.92 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $20.89 | $27.54 |
Where Nebraska sits
The same service costs 5.0 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· 20th 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.