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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $575.44 | Professional | None | $389.05 | $501.19 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $870.96 Typical High $870.96 | Facility | None | $489.78 | $870.96 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,659.59 | Professional | None | $851.14 | $870.96 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $851.14 Typical High $3,311.31 | Facility | None | $489.78 | $851.14 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $645.65 | Professional | None | $295.12 | $389.05 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,659.59 | Professional | None | $851.14 | $851.14 | $1,659.59 |
Midlands Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,659.59 | $2,137.96 |
United Setting Facility Modifier None Typical Low $165.96 Median $758.58 Typical High $758.58 | Facility | None | $165.96 | $758.58 | $758.58 |
United Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $501.19 | Professional | None | $281.84 | $389.05 | $501.19 |
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 $194.98 Median $245.47 Typical High $288.40 | Professional | 52 · Reduced service | $194.98 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $79.43 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $74.13 Typical High $87.10 | Professional | 55 · Aftercare only | $58.88 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $50.12 Typical High $57.54 | Professional | 56 · Pre-op care only | $38.90 | $50.12 | $57.54 |
Where Nebraska sits
The same service costs 2.4 times more in Iowa than in Kansas. 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· 15th of 51
$501
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.