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 $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $6.31 Typical High $11.48 | Professional | None | $5.89 | $6.31 | $11.48 |
Medica Setting Facility Modifier None Typical Low $4.47 Median $9.55 Typical High $89.13 | Facility | None | $4.47 | $9.55 | $89.13 |
Medica Setting Professional Modifier None Typical Low $2.04 Median $2.69 Typical High $5.89 | Professional | None | $2.04 | $2.69 | $5.89 |
Midlands Setting Professional Modifier None Typical Low $5.89 Median $6.03 Typical High $11.48 | Professional | None | $5.89 | $6.03 | $11.48 |
Midlands Setting Professional Modifier None Typical Low $6.76 Median $11.48 Typical High $13.49 | Professional | None | $6.76 | $11.48 | $13.49 |
Oscar Health Setting Professional Modifier None Typical Low $5.50 Median $7.76 Typical High $11.75 | Professional | None | $5.50 | $7.76 | $11.75 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.51 Typical High $3.89 | Professional | None | $1.95 | $2.51 | $3.89 |
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 $2.69 Median $2.69 Typical High $2.69 | Professional | 52 · Reduced service | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 54 · Surgery only | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $0.54 |
Where Nebraska sits
The same service costs 3.8 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· 19th of 51
$4.27
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.