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 $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $20.89 Typical High $38.02 | Professional | None | $19.95 | $20.89 | $38.02 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $31.62 Typical High $89.13 | Facility | None | $14.79 | $31.62 | $89.13 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $8.91 Typical High $19.95 | Professional | None | $6.92 | $8.91 | $19.95 |
Midlands Setting Professional Modifier None Typical Low $19.95 Median $20.42 Typical High $38.02 | Professional | None | $19.95 | $20.42 | $38.02 |
Midlands Setting Professional Modifier None Typical Low $22.39 Median $38.02 Typical High $44.67 | Professional | None | $22.39 | $38.02 | $44.67 |
Oscar Health Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $38.90 | Professional | None | $18.20 | $25.70 | $38.90 |
United Setting Professional Modifier None Typical Low $6.46 Median $8.51 Typical High $12.88 | Professional | None | $6.46 | $8.51 | $12.88 |
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 $9.12 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 54 · Surgery only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.82 |
Where Nebraska sits
The same service costs 2.7 times more in Idaho 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
$14.13
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.