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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $69.18 | Professional | None | $28.84 | $30.90 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $54.95 | Facility | None | $34.67 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $102.33 | Professional | None | $53.70 | $58.88 | $102.33 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $53.70 Typical High $229.09 | Facility | None | $30.90 | $53.70 | $229.09 |
Medica Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $46.77 | Professional | None | $18.62 | $26.30 | $46.77 |
Midlands Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $102.33 | Professional | None | $53.70 | $53.70 | $102.33 |
Midlands Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $131.83 | Professional | None | $67.61 | $102.33 | $131.83 |
United Setting Facility Modifier None Typical Low $16.22 Median $31.62 Typical High $50.12 | Facility | None | $16.22 | $31.62 | $50.12 |
United Setting Professional Modifier None Typical Low $17.38 Median $23.99 Typical High $38.90 | Professional | None | $17.38 | $23.99 | $38.90 |
5 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 $13.18 Median $15.49 Typical High $18.20 | Professional | 52 · Reduced service | $13.18 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.17 Typical High $7.24 | Professional | 53 · Discontinued | $5.25 | $6.17 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.68 Typical High $5.50 | Professional | 55 · Aftercare only | $3.98 | $4.68 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.09 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.63 | $3.09 | $3.63 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | KX · Policy requirements met | $36.31 | $36.31 | $36.31 |
Where Nebraska sits
The same service costs 3.2 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· 21st of 51
$37.15
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.