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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | None | $512.86 | $562.34 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,000.00 | Facility | None | $588.84 | $1,000.00 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,862.09 | Professional | None | $977.24 | $1,047.13 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $977.24 Typical High $4,466.84 | Facility | None | $562.34 | $977.24 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $691.83 | Professional | None | $338.84 | $446.68 | $691.83 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,862.09 | Professional | None | $977.24 | $977.24 | $1,862.09 |
Midlands Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,862.09 | $2,454.71 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,000.00 | Facility | None | $501.19 | $1,000.00 | $1,000.00 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $660.69 | Professional | None | $323.59 | $446.68 | $660.69 |
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 $257.04 Median $281.84 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $66.07 |
Where Nebraska sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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
$661
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.