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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $660.69 | Professional | None | $501.19 | $562.34 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $977.24 | Facility | None | $691.83 | $977.24 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,862.09 | Professional | None | $954.99 | $1,096.48 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $954.99 Typical High $4,466.84 | Facility | None | $562.34 | $954.99 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $691.83 | Professional | None | $331.13 | $436.52 | $691.83 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,862.09 | Professional | None | $954.99 | $954.99 | $1,862.09 |
Midlands Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,862.09 | $2,398.83 |
United Setting Facility Modifier None Typical Low $398.11 Median $954.99 Typical High $954.99 | Facility | None | $398.11 | $954.99 | $954.99 |
United Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $630.96 | Professional | None | $316.23 | $436.52 | $630.96 |
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 $245.47 Median $281.84 Typical High $331.13 | Professional | 52 · Reduced service | $245.47 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $66.07 |
Where Nebraska sits
The same service costs 2.4 times more in Hawaii than in Washington, DC. 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· 20th of 51
$631
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.