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 $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $5.13 Typical High $6.76 | Professional | None | $4.79 | $5.13 | $6.76 |
Ambetter Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $6.17 | Professional | None | $5.50 | $5.50 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $8.91 Typical High $8.91 | Facility | None | $5.13 | $8.91 | $8.91 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $9.33 Typical High $16.98 | Professional | None | $8.71 | $9.33 | $16.98 |
Medica Setting Facility Modifier None Typical Low $5.13 Median $8.71 Typical High $79.43 | Facility | None | $5.13 | $8.71 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $7.76 | Professional | None | $3.02 | $3.98 | $7.76 |
Midlands Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $16.98 | Professional | None | $8.71 | $8.71 | $16.98 |
Midlands Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
Midlands Setting Professional Modifier None Typical Low $11.22 Median $16.98 Typical High $21.88 | Professional | None | $11.22 | $16.98 | $21.88 |
United Setting Facility Modifier None Typical Low $4.79 Median $9.33 Typical High $9.33 | Facility | None | $4.79 | $9.33 | $9.33 |
United Setting Professional Modifier None Typical Low $2.88 Median $3.98 Typical High $6.17 | Professional | None | $2.88 | $3.98 | $6.17 |
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 $2.29 Median $2.57 Typical High $3.02 | Professional | 52 · Reduced service | $2.29 | $2.57 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $1.02 Typical High $1.20 | Professional | 53 · Discontinued | $0.91 | $1.02 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $0.78 Typical High $0.89 | Professional | 55 · Aftercare only | $0.69 | $0.78 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.51 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.46 | $0.51 | $0.60 |
Where Nebraska sits
The same service costs 3.2 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· 19th of 51
$6.17
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.