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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $154.88 | Professional | None | $81.28 | $85.11 | $154.88 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $131.83 Typical High $346.74 | Facility | None | $61.66 | $131.83 | $346.74 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $81.28 | Professional | None | $28.18 | $37.15 | $81.28 |
Midlands Setting Professional Modifier None Typical Low $81.28 Median $83.18 Typical High $154.88 | Professional | None | $81.28 | $83.18 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $186.21 | Professional | None | $91.20 | $154.88 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $158.49 | Professional | None | $75.86 | $104.71 | $158.49 |
United Setting Professional Modifier None Typical Low $26.92 Median $34.67 Typical High $53.70 | Professional | None | $26.92 | $34.67 | $53.70 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 54 · Surgery only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Where Nebraska sits
The same service costs 2.8 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· 19th of 51
$57.54
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.