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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $229.09 | Professional | None | $169.82 | $194.98 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $338.84 Typical High $338.84 | Facility | None | $173.78 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $645.65 | Professional | None | $323.59 | $331.13 | $645.65 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $331.13 Typical High $1,513.56 | Facility | None | $194.98 | $331.13 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $239.88 | Professional | None | $114.82 | $151.36 | $239.88 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $645.65 | Professional | None | $331.13 | $331.13 | $645.65 |
Midlands Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $831.76 | Professional | None | $426.58 | $645.65 | $831.76 |
United Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $323.59 | Facility | None | $186.21 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $213.80 | Professional | None | $109.65 | $151.36 | $213.80 |
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 $79.43 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $79.43 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $31.62 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $23.99 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.85 | $19.50 | $22.91 |
Where Nebraska sits
The same service costs 4.0 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
$214
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.