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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $177.83 | Professional | None | $134.90 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $263.03 Typical High $263.03 | Facility | None | $138.04 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $501.19 | Professional | None | $257.04 | $275.42 | $501.19 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $257.04 Typical High $1,174.90 | Facility | None | $151.36 | $257.04 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $186.21 | Professional | None | $91.20 | $117.49 | $186.21 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $501.19 | Professional | None | $257.04 | $257.04 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $645.65 | Professional | None | $331.13 | $501.19 | $645.65 |
United Setting Facility Modifier None Typical Low $147.91 Median $257.04 Typical High $257.04 | Facility | None | $147.91 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $169.82 | Professional | None | $85.11 | $117.49 | $169.82 |
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 $66.07 Median $75.86 Typical High $89.13 | Professional | 52 · Reduced service | $66.07 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.20 Typical High $35.48 | Professional | 53 · Discontinued | $26.92 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $22.91 Typical High $26.92 | Professional | 55 · Aftercare only | $19.95 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.14 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.49 | $15.14 | $17.78 |
Where Nebraska sits
The same service costs 3.5 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· 18th of 51
$170
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.