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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $346.74 | Professional | None | $263.03 | $302.00 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $524.81 Typical High $524.81 | Facility | None | $316.23 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $1,000.00 | Professional | None | $512.86 | $562.34 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $512.86 Typical High $2,290.87 | Facility | None | $295.12 | $512.86 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $363.08 | Professional | None | $177.83 | $234.42 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,000.00 | Professional | None | $512.86 | $512.86 | $1,000.00 |
Midlands Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,288.25 | Professional | None | $645.65 | $1,000.00 | $1,288.25 |
United Setting Facility Modifier None Typical Low $213.80 Median $512.86 Typical High $512.86 | Facility | None | $213.80 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $338.84 | Professional | None | $169.82 | $234.42 | $338.84 |
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 $131.83 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $131.83 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $52.48 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $39.81 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.30 | $30.20 | $34.67 |
Where Nebraska sits
The same service costs 2.5 times more in Hawaii 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· 18th of 51
$339
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.