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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $398.11 Typical High $398.11 | Facility | None | $269.15 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $758.58 | Professional | None | $389.05 | $446.68 | $758.58 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $389.05 Typical High $1,737.80 | Facility | None | $229.09 | $389.05 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $281.84 | Professional | None | $134.90 | $177.83 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $758.58 | Professional | None | $389.05 | $389.05 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $977.24 | Professional | None | $489.78 | $758.58 | $977.24 |
United Setting Facility Modifier None Typical Low $158.49 Median $389.05 Typical High $389.05 | Facility | None | $158.49 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $257.04 | Professional | None | $128.82 | $177.83 | $257.04 |
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 $102.33 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $102.33 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $40.74 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $30.20 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $26.92 |
Where Nebraska sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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
$257
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.