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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $257.04 | Professional | None | $204.17 | $218.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $389.05 | Facility | None | $245.47 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $724.44 | Professional | None | $380.19 | $426.58 | $724.44 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $380.19 Typical High $1,737.80 | Facility | None | $218.78 | $380.19 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $269.15 | Professional | None | $131.83 | $173.78 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $724.44 | Professional | None | $380.19 | $380.19 | $724.44 |
Midlands Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $954.99 | Professional | None | $478.63 | $724.44 | $954.99 |
United Setting Facility Modifier None Typical Low $169.82 Median $389.05 Typical High $389.05 | Facility | None | $169.82 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $257.04 | Professional | None | $125.89 | $173.78 | $257.04 |
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 $100.00 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $100.00 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $40.74 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $30.20 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.42 | $21.88 | $25.70 |
Where Nebraska sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 19th of 51
$257
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.