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 $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $977.24 | Professional | None | $645.65 | $831.76 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $1,445.44 | Facility | None | $870.96 | $1,445.44 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,584.89 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $1,412.54 Typical High $5,623.41 | Facility | None | $831.76 | $1,412.54 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,023.29 | Professional | None | $489.78 | $645.65 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,412.54 | $2,754.23 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,754.23 | $3,548.13 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,258.93 Typical High $1,258.93 | Facility | None | $616.60 | $1,258.93 | $1,258.93 |
United Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $831.76 | Professional | None | $467.74 | $645.65 | $831.76 |
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 $323.59 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $323.59 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $128.82 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $97.72 |
Where Nebraska sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 21st of 51
$832
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.