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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $16.60 Typical High $21.38 | Professional | None | $14.45 | $16.60 | $21.38 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $19.95 | Professional | None | $15.85 | $15.85 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $28.84 Typical High $28.84 | Facility | None | $16.22 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $29.51 Typical High $54.95 | Professional | None | $28.18 | $29.51 | $54.95 |
Medica Setting Facility Modifier None Typical Low $16.60 Median $28.18 Typical High $125.89 | Facility | None | $16.60 | $28.18 | $125.89 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $12.88 Typical High $24.55 | Professional | None | $9.77 | $12.88 | $24.55 |
Midlands Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $54.95 | Professional | None | $28.18 | $28.18 | $54.95 |
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 $54.95 Typical High $70.79 | Professional | None | $35.48 | $54.95 | $70.79 |
United Setting Facility Modifier None Typical Low $12.88 Median $26.92 Typical High $26.92 | Facility | None | $12.88 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $9.33 Median $12.88 Typical High $17.78 | Professional | None | $9.33 | $12.88 | $17.78 |
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 $7.08 Median $8.32 Typical High $9.77 | Professional | 52 · Reduced service | $7.08 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.31 Typical High $3.89 | Professional | 53 · Discontinued | $2.82 | $3.31 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.45 Typical High $2.88 | Professional | 55 · Aftercare only | $2.09 | $2.45 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.66 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.41 | $1.66 | $1.95 |
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· 23rd of 51
$17.78
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.