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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $93.33 | Professional | None | $47.86 | $51.29 | $93.33 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $77.62 Typical High $204.17 | Facility | None | $36.31 | $77.62 | $204.17 |
Medica Setting Professional Modifier None Typical Low $16.60 Median $21.88 Typical High $47.86 | Professional | None | $16.60 | $21.88 | $47.86 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $93.33 | Professional | None | $47.86 | $48.98 | $93.33 |
Midlands Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $109.65 | Professional | None | $54.95 | $93.33 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $95.50 | Professional | None | $44.67 | $63.10 | $95.50 |
United Setting Professional Modifier None Typical Low $15.85 Median $20.89 Typical High $31.62 | Professional | None | $15.85 | $20.89 | $31.62 |
5 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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 54 · Surgery only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Where Nebraska sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 18th of 51
$34.67
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.