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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $173.78 | Professional | None | $114.82 | $151.36 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $263.03 | Facility | None | $125.89 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $501.19 | Professional | None | $257.04 | $275.42 | $501.19 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $257.04 Typical High $1,047.13 | Facility | None | $147.91 | $257.04 | $1,047.13 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $181.97 | Professional | None | $89.13 | $117.49 | $181.97 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $501.19 | Professional | None | $257.04 | $257.04 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $645.65 | Professional | None | $323.59 | $501.19 | $645.65 |
United Setting Facility Modifier None Typical Low $100.00 Median $223.87 Typical High $223.87 | Facility | None | $100.00 | $223.87 | $223.87 |
United Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $147.91 | Professional | None | $85.11 | $117.49 | $147.91 |
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 $57.54 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $57.54 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.20 Typical High $35.48 | Professional | 53 · Discontinued | $22.91 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $17.38 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.14 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.48 | $15.14 | $17.38 |
Where Nebraska sits
The same service costs 2.9 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· 19th of 51
$151
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.