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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $100.00 | Professional | None | $52.48 | $54.95 | $100.00 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $85.11 Typical High $223.87 | Facility | None | $38.90 | $85.11 | $223.87 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $23.44 Typical High $75.86 | Professional | None | $18.20 | $23.44 | $75.86 |
Midlands Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $100.00 | Professional | None | $52.48 | $53.70 | $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 $48.98 Median $67.61 Typical High $102.33 | Professional | None | $48.98 | $67.61 | $102.33 |
United Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $34.67 | Professional | None | $17.38 | $22.39 | $34.67 |
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 $23.99 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.55 | $9.55 | $9.55 |
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 $4.79 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
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· 17th 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.