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 $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $30.90 | Professional | None | $11.75 | $11.75 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $13.49 Typical High $24.55 | Professional | None | $12.88 | $13.49 | $24.55 |
Medica Setting Facility Modifier None Typical Low $9.77 Median $20.89 Typical High $89.13 | Facility | None | $9.77 | $20.89 | $89.13 |
Medica Setting Professional Modifier None Typical Low $4.47 Median $5.75 Typical High $12.88 | Professional | None | $4.47 | $5.75 | $12.88 |
Midlands Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $24.55 | Professional | None | $12.88 | $13.18 | $24.55 |
Midlands Setting Professional Modifier None Typical Low $14.45 Median $24.55 Typical High $29.51 | Professional | None | $14.45 | $24.55 | $29.51 |
Oscar Health Setting Professional Modifier None Typical Low $12.02 Median $16.60 Typical High $25.12 | Professional | None | $12.02 | $16.60 | $25.12 |
United Setting Professional Modifier None Typical Low $4.27 Median $5.50 Typical High $8.51 | Professional | None | $4.27 | $5.50 | $8.51 |
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 $5.89 Median $5.89 Typical High $5.89 | Professional | 52 · Reduced service | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | 53 · Discontinued | $2.34 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 54 · Surgery only | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.17 |
Where Nebraska sits
The same service costs 2.9 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· 19th of 51
$9.12
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.