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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,479.11 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $2,570.40 | Facility | None | $1,819.70 | $2,570.40 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $2,884.03 Typical High $4,897.79 | Professional | None | $2,511.89 | $2,884.03 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $2,511.89 Typical High $12,022.64 | Facility | None | $1,445.44 | $2,511.89 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $2,290.87 | Professional | None | $870.96 | $1,148.15 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $4,897.79 | Professional | None | $2,511.89 | $2,511.89 | $4,897.79 |
Midlands Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $3,162.28 Median $4,897.79 Typical High $6,309.57 | Professional | None | $3,162.28 | $4,897.79 | $6,309.57 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,630.27 Typical High $2,630.27 | Facility | None | $870.96 | $2,630.27 | $2,630.27 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,737.80 | Professional | None | $831.76 | $1,148.15 | $1,737.80 |
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 $691.83 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $346.74 | Professional | 53 · Discontinued | $275.42 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $218.78 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $169.82 |
Where Nebraska sits
The same service costs 2.3 times more in Wisconsin than in Pennsylvania. 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
$1,738
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.