How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | None | $61.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $15.14 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $15.14 |
BCBS Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
BCBS Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $194.98 | Professional | None | $134.90 | $169.82 | $194.98 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $162.18 Median $204.17 Typical High $234.42 | Professional | 22 · Increased work | $162.18 | $204.17 | $234.42 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $26.92 | $33.88 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $181.97 | Facility | None | $158.49 | $158.49 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $102.33 Typical High $125.89 | Professional | None | $56.23 | $102.33 | $125.89 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $141.25 | Facility | None | $81.28 | $81.28 | $141.25 |
3 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 $40.74 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $40.74 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $20.42 | Professional | 53 · Discontinued | $16.22 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $10.00 |
Where North Dakota sits
The same service costs 13.8 times more in Indiana than in Pennsylvania. 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.
North Dakota· 10th of 51
$135
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.