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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $302.00 | Professional | None | $218.78 | $257.04 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $446.68 Typical High $446.68 | Facility | None | $229.09 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $851.14 | Professional | None | $426.58 | $436.52 | $851.14 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $436.52 Typical High $1,905.46 | Facility | None | $257.04 | $436.52 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $316.23 | Professional | None | $151.36 | $199.53 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $851.14 | Professional | None | $436.52 | $436.52 | $851.14 |
Midlands Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,096.48 | Professional | None | $549.54 | $851.14 | $1,096.48 |
United Setting Facility Modifier None Typical Low $151.36 Median $426.58 Typical High $426.58 | Facility | None | $151.36 | $426.58 | $426.58 |
United Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $281.84 | Professional | None | $144.54 | $199.53 | $281.84 |
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 $104.71 Median $128.82 Typical High $151.36 | Professional | 52 · Reduced service | $104.71 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $51.29 Typical High $60.26 | Professional | 53 · Discontinued | $41.69 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $38.90 Typical High $44.67 | Professional | 55 · Aftercare only | $30.90 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $25.70 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.89 | $25.70 | $30.20 |
Where Nebraska sits
The same service costs 2.7 times more in Montana than in Delaware. 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· 18th of 51
$282
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.