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 $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,445.44 | Professional | None | $912.01 | $912.01 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,202.26 | $1,621.81 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,584.89 | $1,819.70 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $1,584.89 Typical High $7,585.78 | Facility | None | $912.01 | $1,584.89 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,412.54 | Professional | None | $549.54 | $724.44 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,584.89 | $1,584.89 | $3,090.30 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $3,981.07 | Professional | None | $1,995.26 | $3,090.30 | $3,981.07 |
United Setting Facility Modifier None Typical Low $457.09 Median $1,659.59 Typical High $1,659.59 | Facility | None | $457.09 | $1,659.59 | $1,659.59 |
United Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,096.48 | Professional | None | $524.81 | $724.44 | $1,096.48 |
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 $436.52 Median $457.09 Typical High $537.03 | Professional | 52 · Reduced service | $436.52 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $162.18 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $107.15 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $107.15 |
Where Nebraska sits
The same service costs 2.6 times more in Montana 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· 25th of 51
$1,096
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.