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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $177.83 | Professional | None | $91.20 | $97.72 | $177.83 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $147.91 Typical High $389.05 | Facility | None | $69.18 | $147.91 | $389.05 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $91.20 | Professional | None | $31.62 | $41.69 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $177.83 | Professional | None | $91.20 | $93.33 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $208.93 | Professional | None | $104.71 | $177.83 | $208.93 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $181.97 | Professional | None | $85.11 | $120.23 | $181.97 |
United Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $60.26 | Professional | None | $30.20 | $39.81 | $60.26 |
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 $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 54 · Surgery only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
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
$66.07
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.