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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $114.82 | Professional | None | $89.13 | $97.72 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $117.49 | Professional | None | $77.62 | $77.62 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $173.78 Typical High $173.78 | Facility | None | $100.00 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $323.59 | Professional | None | $169.82 | $177.83 | $323.59 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $169.82 Typical High $724.44 | Facility | None | $97.72 | $169.82 | $724.44 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $151.36 | Professional | None | $58.88 | $77.62 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $323.59 | Professional | None | $169.82 | $169.82 | $323.59 |
Midlands Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $426.58 | Professional | None | $213.80 | $323.59 | $426.58 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $107.15 | Professional | None | $56.23 | $77.62 | $107.15 |
2 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 55 · Aftercare only Typical Low $12.30 Median $14.79 Typical High $17.38 | Professional | 55 · Aftercare only | $12.30 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.77 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.32 | $9.77 | $11.48 |
Where Nebraska sits
The same service costs 2.2 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· 20th of 51
$107
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.