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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $50.12 | Professional | None | $25.70 | $27.54 | $50.12 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $41.69 Typical High $131.83 | Facility | None | $19.50 | $41.69 | $131.83 |
Medica Setting Professional Modifier None Typical Low $8.91 Median $11.75 Typical High $25.70 | Professional | None | $8.91 | $11.75 | $25.70 |
Midlands Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $50.12 | Professional | None | $25.70 | $26.30 | $50.12 |
Midlands Setting Professional Modifier None Typical Low $29.51 Median $50.12 Typical High $58.88 | Professional | None | $29.51 | $50.12 | $58.88 |
Oscar Health Setting Professional Modifier None Typical Low $23.99 Median $33.88 Typical High $51.29 | Professional | None | $23.99 | $33.88 | $51.29 |
United Setting Professional Modifier None Typical Low $8.51 Median $11.22 Typical High $16.98 | Professional | None | $8.51 | $11.22 | $16.98 |
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 $11.75 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 54 · Surgery only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $2.34 |
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· 18th of 51
$18.62
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.