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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $81.28 | Professional | None | $33.11 | $33.11 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $70.79 | Professional | None | $36.31 | $38.90 | $70.79 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $58.88 Typical High $154.88 | Facility | None | $27.54 | $58.88 | $154.88 |
Medica Setting Professional Modifier None Typical Low $12.59 Median $16.60 Typical High $45.71 | Professional | None | $12.59 | $16.60 | $45.71 |
Midlands Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $70.79 | Professional | None | $36.31 | $37.15 | $70.79 |
Midlands Setting Professional Modifier None Typical Low $41.69 Median $70.79 Typical High $83.18 | Professional | None | $41.69 | $70.79 | $83.18 |
Oscar Health Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $72.44 | Professional | None | $33.88 | $47.86 | $72.44 |
United Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $23.99 | Professional | None | $12.02 | $15.85 | $23.99 |
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 $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 54 · Surgery only | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
Where Nebraska sits
The same service costs 2.6 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· 20th of 51
$25.70
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.