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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $37.15 | Professional | None | $15.14 | $15.14 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $32.36 | Professional | None | $16.60 | $17.78 | $32.36 |
Medica Setting Facility Modifier None Typical Low $12.59 Median $26.92 Typical High $125.89 | Facility | None | $12.59 | $26.92 | $125.89 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $7.59 Typical High $20.89 | Professional | None | $5.75 | $7.59 | $20.89 |
Midlands Setting Professional Modifier None Typical Low $16.60 Median $16.98 Typical High $32.36 | Professional | None | $16.60 | $16.98 | $32.36 |
Midlands Setting Professional Modifier None Typical Low $19.05 Median $32.36 Typical High $38.02 | Professional | None | $19.05 | $32.36 | $38.02 |
Oscar Health Setting Professional Modifier None Typical Low $15.49 Median $21.88 Typical High $33.11 | Professional | None | $15.49 | $21.88 | $33.11 |
United Setting Professional Modifier None Typical Low $5.50 Median $7.24 Typical High $10.96 | Professional | None | $5.50 | $7.24 | $10.96 |
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 $7.59 Median $7.59 Typical High $7.59 | Professional | 52 · Reduced service | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 54 · Surgery only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $1.51 |
Where Nebraska sits
The same service costs 4.5 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· 13th of 51
$13.80
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.