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 $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.61 Typical High $12.02 | Professional | None | $6.31 | $6.61 | $12.02 |
Medica Setting Facility Modifier None Typical Low $4.68 Median $10.00 Typical High $89.13 | Facility | None | $4.68 | $10.00 | $89.13 |
Medica Setting Professional Modifier None Typical Low $2.19 Median $2.82 Typical High $6.31 | Professional | None | $2.19 | $2.82 | $6.31 |
Midlands Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $12.02 | Professional | None | $6.31 | $6.31 | $12.02 |
Midlands Setting Professional Modifier None Typical Low $7.08 Median $12.02 Typical High $14.13 | Professional | None | $7.08 | $12.02 | $14.13 |
Oscar Health Setting Professional Modifier None Typical Low $5.75 Median $8.13 Typical High $12.30 | Professional | None | $5.75 | $8.13 | $12.30 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.69 Typical High $4.07 | Professional | None | $2.04 | $2.69 | $4.07 |
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 $2.82 Median $2.82 Typical High $2.82 | Professional | 52 · Reduced service | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 54 · Surgery only | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 55 · Aftercare only | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.56 |
Where Nebraska sits
The same service costs 3.0 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· 20th of 51
$4.47
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.