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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $89.13 | Professional | None | $36.31 | $36.31 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $77.62 | Professional | None | $39.81 | $42.66 | $77.62 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $64.57 Typical High $199.53 | Facility | None | $30.20 | $64.57 | $199.53 |
Medica Setting Professional Modifier None Typical Low $13.80 Median $18.20 Typical High $41.69 | Professional | None | $13.80 | $18.20 | $41.69 |
Midlands Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $77.62 | Professional | None | $39.81 | $40.74 | $77.62 |
Midlands Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $91.20 | Professional | None | $45.71 | $77.62 | $91.20 |
Oscar Health Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $79.43 | Professional | None | $37.15 | $52.48 | $79.43 |
United Setting Professional Modifier None Typical Low $13.18 Median $17.38 Typical High $26.30 | Professional | None | $13.18 | $17.38 | $26.30 |
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 $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 54 · Surgery only | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Where Nebraska sits
The same service costs 3.1 times more in Rhode Island 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· 23rd of 51
$28.84
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.