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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $524.81 | Professional | None | $338.84 | $398.11 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $691.83 | Facility | None | $371.54 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,318.26 | Professional | None | $676.08 | $676.08 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $676.08 Typical High $2,951.21 | Facility | None | $389.05 | $676.08 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $478.63 | Professional | None | $213.80 | $309.03 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,318.26 | Professional | None | $676.08 | $676.08 | $1,318.26 |
Midlands Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $1,698.24 | Professional | None | $851.14 | $1,318.26 | $1,698.24 |
United Setting Facility Modifier None Typical Low $269.15 Median $645.65 Typical High $645.65 | Facility | None | $269.15 | $645.65 | $645.65 |
United Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $416.87 | Professional | None | $223.87 | $309.03 | $416.87 |
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 $165.96 Median $199.53 Typical High $263.03 | Professional | 52 · Reduced service | $165.96 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $79.43 Typical High $107.15 | Professional | 53 · Discontinued | $67.61 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $79.43 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $39.81 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.88 | $39.81 | $52.48 |
Where Nebraska sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 19th of 51
$398
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.