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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $52.48 | Professional | None | $27.54 | $28.84 | $52.48 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $44.67 Typical High $117.49 | Facility | None | $20.89 | $44.67 | $117.49 |
Medica Setting Professional Modifier None Typical Low $9.55 Median $12.59 Typical High $27.54 | Professional | None | $9.55 | $12.59 | $27.54 |
Midlands Setting Professional Modifier None Typical Low $27.54 Median $28.18 Typical High $52.48 | Professional | None | $27.54 | $28.18 | $52.48 |
Midlands Setting Professional Modifier None Typical Low $30.90 Median $52.48 Typical High $63.10 | Professional | None | $30.90 | $52.48 | $63.10 |
Oscar Health Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $53.70 | Professional | None | $25.70 | $35.48 | $53.70 |
United Setting Professional Modifier None Typical Low $9.12 Median $11.75 Typical High $18.20 | Professional | None | $9.12 | $11.75 | $18.20 |
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 $12.59 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 54 · Surgery only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
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· 18th of 51
$19.50
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.