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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $22.91 Typical High $41.69 | Professional | None | $21.38 | $22.91 | $41.69 |
Medica Setting Facility Modifier None Typical Low $16.22 Median $34.67 Typical High $91.20 | Facility | None | $16.22 | $34.67 | $91.20 |
Medica Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $21.88 | Professional | None | $7.41 | $9.77 | $21.88 |
Midlands Setting Professional Modifier None Typical Low $21.38 Median $21.88 Typical High $41.69 | Professional | None | $21.38 | $21.88 | $41.69 |
Midlands Setting Professional Modifier None Typical Low $24.55 Median $41.69 Typical High $48.98 | Professional | None | $24.55 | $41.69 | $48.98 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $28.18 Typical High $42.66 | Professional | None | $19.95 | $28.18 | $42.66 |
United Setting Professional Modifier None Typical Low $7.08 Median $9.33 Typical High $14.13 | Professional | None | $7.08 | $9.33 | $14.13 |
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 $9.77 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 54 · Surgery only | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $1.95 |
Where Nebraska sits
The same service costs 2.8 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
$15.49
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.