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 $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $16.22 Typical High $19.05 | Professional | None | $14.79 | $16.22 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $28.84 Typical High $28.84 | Facility | None | $16.60 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.84 Typical High $53.70 | Professional | None | $28.18 | $28.84 | $53.70 |
Medica Setting Facility Modifier None Typical Low $16.22 Median $27.54 Typical High $131.83 | Facility | None | $16.22 | $27.54 | $131.83 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $12.59 Typical High $21.38 | Professional | None | $9.77 | $12.59 | $21.38 |
Midlands Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $53.70 | Professional | None | $28.18 | $28.18 | $53.70 |
Midlands Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Midlands Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $69.18 | Professional | None | $35.48 | $53.70 | $69.18 |
United Setting Facility Modifier None Typical Low $12.88 Median $28.84 Typical High $28.84 | Facility | None | $12.88 | $28.84 | $28.84 |
United Setting Professional Modifier None Typical Low $9.12 Median $12.59 Typical High $19.05 | Professional | None | $9.12 | $12.59 | $19.05 |
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 $7.08 Median $8.13 Typical High $9.55 | Professional | 52 · Reduced service | $7.08 | $8.13 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.24 Typical High $3.80 | Professional | 53 · Discontinued | $2.82 | $3.24 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.45 Typical High $2.88 | Professional | 55 · Aftercare only | $2.14 | $2.45 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.62 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.41 | $1.62 | $1.91 |
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· 21st of 51
$19.05
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.