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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $537.03 | Professional | None | $389.05 | $457.09 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $794.33 Typical High $794.33 | Facility | None | $398.11 | $794.33 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,513.56 | Professional | None | $776.25 | $891.25 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $776.25 Typical High $3,630.78 | Facility | None | $446.68 | $776.25 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $549.54 | Professional | None | $269.15 | $354.81 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,513.56 | Professional | None | $776.25 | $776.25 | $1,513.56 |
Midlands Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $1,949.84 | Professional | None | $977.24 | $1,513.56 | $1,949.84 |
United Setting Facility Modifier None Typical Low $371.54 Median $741.31 Typical High $741.31 | Facility | None | $371.54 | $741.31 | $741.31 |
United Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $489.78 | Professional | None | $257.04 | $354.81 | $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 $194.98 Median $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $194.98 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $77.62 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $53.70 |
Where Nebraska sits
The same service costs 2.8 times more in Wisconsin 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
$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.