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 $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $501.19 | Professional | None | $380.19 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $758.58 | Facility | None | $524.81 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,412.54 | Professional | None | $741.31 | $831.76 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $724.44 Typical High $3,388.44 | Facility | None | $426.58 | $724.44 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $524.81 | Professional | None | $257.04 | $331.13 | $524.81 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,412.54 | Professional | None | $741.31 | $741.31 | $1,412.54 |
Midlands Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $1,819.70 | Professional | None | $933.25 | $1,412.54 | $1,819.70 |
United Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $741.31 | Facility | None | $302.00 | $741.31 | $741.31 |
United Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $489.78 | Professional | None | $239.88 | $331.13 | $489.78 |
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 $190.55 Median $213.80 Typical High $251.19 | Professional | 52 · Reduced service | $190.55 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $75.86 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $75.86 | Professional | 55 · Aftercare only | $57.54 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $50.12 |
Where Nebraska sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 21st of 51
$490
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.