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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $371.54 | Professional | None | $239.88 | $316.23 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $549.54 Typical High $549.54 | Facility | None | $275.42 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $1,047.13 | Professional | None | $489.78 | $537.03 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $537.03 Typical High $2,238.72 | Facility | None | $316.23 | $537.03 | $2,238.72 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $389.05 | Professional | None | $186.21 | $245.47 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,047.13 | Professional | None | $537.03 | $537.03 | $1,047.13 |
Midlands Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,348.96 | Professional | None | $676.08 | $1,047.13 | $1,348.96 |
United Setting Facility Modifier None Typical Low $218.78 Median $478.63 Typical High $478.63 | Facility | None | $218.78 | $478.63 | $478.63 |
United Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $316.23 | Professional | None | $177.83 | $245.47 | $316.23 |
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 $120.23 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $120.23 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $47.86 Typical High $54.95 | Professional | 55 · Aftercare only | $36.31 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.99 | $31.62 | $37.15 |
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· 18th of 51
$316
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.