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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $75.86 | Professional | None | $39.81 | $41.69 | $75.86 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $64.57 Typical High $169.82 | Facility | None | $30.20 | $64.57 | $169.82 |
Medica Setting Professional Modifier None Typical Low $13.80 Median $18.20 Typical High $39.81 | Professional | None | $13.80 | $18.20 | $39.81 |
Midlands Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $75.86 | Professional | None | $39.81 | $40.74 | $75.86 |
Midlands Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $91.20 | Professional | None | $44.67 | $75.86 | $91.20 |
Oscar Health Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $77.62 | Professional | None | $37.15 | $51.29 | $77.62 |
United Setting Professional Modifier None Typical Low $13.18 Median $16.98 Typical High $26.30 | Professional | None | $13.18 | $16.98 | $26.30 |
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 $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 54 · Surgery only | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
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· 18th of 51
$28.18
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.