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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $426.58 | Professional | None | $316.23 | $363.08 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $630.96 Typical High $630.96 | Facility | None | $398.11 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,202.26 | Professional | None | $616.60 | $707.95 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $616.60 Typical High $2,754.23 | Facility | None | $363.08 | $616.60 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $446.68 | Professional | None | $213.80 | $281.84 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,202.26 | Professional | None | $616.60 | $616.60 | $1,202.26 |
Midlands Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,548.82 | Professional | None | $794.33 | $1,202.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $257.04 Median $616.60 Typical High $616.60 | Facility | None | $257.04 | $616.60 | $616.60 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $407.38 | Professional | None | $204.17 | $281.84 | $407.38 |
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 $158.49 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $158.49 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $63.10 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $47.86 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $31.62 | $36.31 | $42.66 |
Where Nebraska sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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
$407
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.