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 $758.58 Median $831.76 Typical High $977.24 | Professional | None | $758.58 | $831.76 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Facility | None | $912.01 | $1,445.44 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,479.11 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $1,412.54 Typical High $6,760.83 | Facility | None | $812.83 | $1,412.54 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,000.00 | Professional | None | $489.78 | $645.65 | $1,000.00 |
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 $575.44 Median $1,479.11 Typical High $1,479.11 | Facility | None | $575.44 | $1,479.11 | $1,479.11 |
United Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,000.00 | Professional | None | $467.74 | $645.65 | $1,000.00 |
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 $380.19 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $151.36 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $97.72 |
Where Nebraska sits
The same service costs 2.3 times more in Hawaii than in New Jersey. 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
$1,000
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.