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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $323.59 | Professional | None | $229.09 | $245.47 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $295.12 | Professional | None | $194.98 | $194.98 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $426.58 Typical High $426.58 | Facility | None | $245.47 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $812.83 | Professional | None | $416.87 | $446.68 | $812.83 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $416.87 Typical High $1,995.26 | Facility | None | $245.47 | $416.87 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $371.54 | Professional | None | $144.54 | $190.55 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $812.83 | Professional | None | $416.87 | $416.87 | $812.83 |
Midlands Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,047.13 | Professional | None | $524.81 | $812.83 | $1,047.13 |
United Setting Facility Modifier None Typical Low $190.55 Median $436.52 Typical High $436.52 | Facility | None | $190.55 | $436.52 | $436.52 |
United Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $295.12 | Professional | None | $138.04 | $190.55 | $295.12 |
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 $112.20 Median $123.03 Typical High $144.54 | Professional | 52 · Reduced service | $112.20 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $48.98 Typical High $57.54 | Professional | 53 · Discontinued | $44.67 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $33.11 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $24.55 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.39 | $24.55 | $28.84 |
Where Nebraska sits
The same service costs 2.5 times more in Kansas than in Florida. 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· 23rd of 51
$295
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.