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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | None | $147.91 | $147.91 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $257.04 Typical High $257.04 | Facility | None | $173.78 | $257.04 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $489.78 | Professional | None | $251.19 | $288.40 | $489.78 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $251.19 Typical High $1,071.52 | Facility | None | $144.54 | $251.19 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $177.83 | Professional | None | $87.10 | $114.82 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $489.78 | Professional | None | $251.19 | $251.19 | $489.78 |
Midlands Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $630.96 | Professional | None | $316.23 | $489.78 | $630.96 |
United Setting Facility Modifier None Typical Low $85.11 Median $239.88 Typical High $239.88 | Facility | None | $85.11 | $239.88 | $239.88 |
United Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $158.49 | Professional | None | $83.18 | $114.82 | $158.49 |
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 $63.10 Median $72.44 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $34.67 | Professional | 53 · Discontinued | $25.12 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $25.70 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $14.79 | $16.98 |
Where Nebraska sits
The same service costs 2.0 times more in Wisconsin than in Delaware. 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· 22nd of 51
$158
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.