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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $85.11 | Professional | None | $61.66 | $72.44 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $125.89 | Facility | None | $91.20 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $239.88 | Professional | None | $123.03 | $131.83 | $239.88 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $123.03 Typical High $537.03 | Facility | None | $72.44 | $123.03 | $537.03 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $89.13 | Professional | None | $42.66 | $56.23 | $89.13 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $239.88 | Professional | None | $123.03 | $123.03 | $239.88 |
Midlands Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $309.03 | Professional | None | $158.49 | $239.88 | $309.03 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $40.74 Median $56.23 Typical High $77.62 | Professional | None | $40.74 | $56.23 | $77.62 |
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 $30.20 Median $36.31 Typical High $42.66 | Professional | 52 · Reduced service | $30.20 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $12.30 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.96 Typical High $12.88 | Professional | 55 · Aftercare only | $9.12 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.24 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.17 | $7.24 | $8.51 |
Where Nebraska sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 24th of 51
$77.62
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.