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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $48.98 Typical High $89.13 | Professional | None | $45.71 | $48.98 | $89.13 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $194.98 | Facility | None | $34.67 | $74.13 | $194.98 |
Medica Setting Professional Modifier None Typical Low $15.85 Median $20.89 Typical High $45.71 | Professional | None | $15.85 | $20.89 | $45.71 |
Midlands Setting Professional Modifier None Typical Low $45.71 Median $46.77 Typical High $89.13 | Professional | None | $45.71 | $46.77 | $89.13 |
Midlands Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $104.71 | Professional | None | $52.48 | $89.13 | $104.71 |
Oscar Health Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $91.20 | Professional | None | $42.66 | $60.26 | $91.20 |
United Setting Professional Modifier None Typical Low $15.14 Median $19.95 Typical High $30.20 | Professional | None | $15.14 | $19.95 | $30.20 |
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 $20.89 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 54 · Surgery only | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.17 |
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
$33.11
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.