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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $512.86 | Professional | None | $380.19 | $436.52 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $776.25 | Facility | None | $467.74 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,445.44 | Professional | None | $758.58 | $831.76 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $758.58 Typical High $3,311.31 | Facility | None | $436.52 | $758.58 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $537.03 | Professional | None | $263.03 | $346.74 | $537.03 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,445.44 | Professional | None | $758.58 | $758.58 | $1,445.44 |
Midlands Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,905.46 | Professional | None | $954.99 | $1,445.44 | $1,905.46 |
United Setting Facility Modifier None Typical Low $380.19 Median $724.44 Typical High $724.44 | Facility | None | $380.19 | $724.44 | $724.44 |
United Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $478.63 | Professional | None | $251.19 | $346.74 | $478.63 |
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 $186.21 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $186.21 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $75.86 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $56.23 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.02 | $43.65 | $51.29 |
Where Nebraska sits
The same service costs 2.9 times more in Hawaii 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· 18th of 51
$479
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.