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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $144.54 | Professional | None | $95.50 | $123.03 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $213.80 Typical High $213.80 | Facility | None | $100.00 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $407.38 | Professional | None | $186.21 | $208.93 | $407.38 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $208.93 Typical High $831.76 | Facility | None | $123.03 | $208.93 | $831.76 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $151.36 | Professional | None | $72.44 | $95.50 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $407.38 | Professional | None | $208.93 | $208.93 | $407.38 |
Midlands Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $524.81 | Professional | None | $263.03 | $407.38 | $524.81 |
United Setting Facility Modifier None Typical Low $102.33 Median $186.21 Typical High $186.21 | Facility | None | $102.33 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $123.03 | Professional | None | $69.18 | $95.50 | $123.03 |
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 $46.77 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $46.77 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $18.62 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $14.13 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.33 | $12.30 | $14.45 |
Where Nebraska sits
The same service costs 4.1 times more in Hawaii 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· 17th of 51
$123
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.