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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $562.34 | Professional | None | $426.58 | $478.63 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $831.76 Typical High $831.76 | Facility | None | $398.11 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,584.89 | Professional | None | $812.83 | $870.96 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $812.83 Typical High $3,311.31 | Facility | None | $478.63 | $812.83 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $588.84 | Professional | None | $281.84 | $371.54 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,584.89 | Professional | None | $812.83 | $812.83 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,584.89 | $2,041.74 |
United Setting Facility Modifier None Typical Low $363.08 Median $724.44 Typical High $724.44 | Facility | None | $363.08 | $724.44 | $724.44 |
United Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $489.78 | Professional | None | $269.15 | $371.54 | $489.78 |
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 $190.55 Median $239.88 Typical High $281.84 | Professional | 52 · Reduced service | $190.55 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $112.20 | Professional | 53 · Discontinued | $75.86 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $57.54 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $47.86 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.02 | $47.86 | $56.23 |
Where Nebraska sits
The same service costs 2.8 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· 14th of 51
$575
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.