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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $100.00 | Professional | None | $51.29 | $54.95 | $100.00 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $83.18 Typical High $263.03 | Facility | None | $38.90 | $83.18 | $263.03 |
Medica Setting Professional Modifier None Typical Low $17.78 Median $23.44 Typical High $52.48 | Professional | None | $17.78 | $23.44 | $52.48 |
Midlands Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $100.00 | Professional | None | $51.29 | $52.48 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $117.49 | Professional | None | $58.88 | $100.00 | $117.49 |
Oscar Health Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $102.33 | Professional | None | $47.86 | $67.61 | $102.33 |
United Setting Professional Modifier None Typical Low $16.98 Median $22.39 Typical High $33.88 | Professional | None | $16.98 | $22.39 | $33.88 |
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 $23.44 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 54 · Surgery only | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $4.68 |
Where Nebraska sits
The same service costs 3.2 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
$37.15
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.