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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $14.13 Typical High $16.60 | Professional | None | $11.22 | $14.13 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $24.55 Typical High $24.55 | Facility | None | $14.45 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $23.99 Typical High $46.77 | Professional | None | $21.88 | $23.99 | $46.77 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $23.99 Typical High $102.33 | Facility | None | $14.13 | $23.99 | $102.33 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $10.96 Typical High $17.38 | Professional | None | $8.32 | $10.96 | $17.38 |
Midlands Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $46.77 | Professional | None | $23.99 | $23.99 | $46.77 |
Midlands Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Midlands Setting Professional Modifier None Typical Low $30.20 Median $46.77 Typical High $60.26 | Professional | None | $30.20 | $46.77 | $60.26 |
United Setting Facility Modifier None Typical Low $12.59 Median $21.88 Typical High $21.88 | Facility | None | $12.59 | $21.88 | $21.88 |
United Setting Professional Modifier None Typical Low $7.94 Median $10.96 Typical High $14.45 | Professional | None | $7.94 | $10.96 | $14.45 |
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 $5.37 Median $7.08 Typical High $8.32 | Professional | 52 · Reduced service | $5.37 | $7.08 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.82 Typical High $3.31 | Professional | 53 · Discontinued | $2.14 | $2.82 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $2.09 Typical High $2.45 | Professional | 55 · Aftercare only | $1.62 | $2.09 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.41 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.07 | $1.41 | $1.66 |
Where Nebraska sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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· 28th of 51
$14.13
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.