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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $309.03 | Professional | None | $186.21 | $186.21 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $323.59 Typical High $323.59 | Facility | None | $177.83 | $323.59 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $616.60 | Professional | None | $316.23 | $363.08 | $616.60 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $316.23 Typical High $1,513.56 | Facility | None | $186.21 | $316.23 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $223.87 | Professional | None | $109.65 | $144.54 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $616.60 | Professional | None | $316.23 | $316.23 | $616.60 |
Midlands Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $794.33 | Professional | None | $398.11 | $616.60 | $794.33 |
United Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $323.59 | Facility | None | $186.21 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $213.80 | Professional | None | $104.71 | $144.54 | $213.80 |
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 $83.18 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $83.18 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $33.11 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $21.88 |
Where Nebraska sits
The same service costs 3.5 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
$214
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.