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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Ambetter Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $42.66 | Professional | None | $28.84 | $28.84 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $54.95 | Professional | None | $28.18 | $30.20 | $54.95 |
Medica Setting Facility Modifier None Typical Low $21.38 Median $45.71 Typical High $158.49 | Facility | None | $21.38 | $45.71 | $158.49 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $12.88 Typical High $29.51 | Professional | None | $9.77 | $12.88 | $29.51 |
Midlands Setting Professional Modifier None Typical Low $28.18 Median $28.84 Typical High $54.95 | Professional | None | $28.18 | $28.84 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $32.36 Median $54.95 Typical High $64.57 | Professional | None | $32.36 | $54.95 | $64.57 |
Oscar Health Setting Professional Modifier None Typical Low $26.30 Median $36.31 Typical High $56.23 | Professional | None | $26.30 | $36.31 | $56.23 |
United Setting Professional Modifier None Typical Low $9.33 Median $12.30 Typical High $18.62 | Professional | None | $9.33 | $12.30 | $18.62 |
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 $12.88 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 54 · Surgery only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.57 |
Where Nebraska sits
The same service costs 3.5 times more in Rhode Island 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· 20th of 51
$19.95
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.