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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $234.42 | Facility | None | $190.55 | $223.87 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $190.55 | Professional | None | $125.89 | $158.49 | $190.55 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $81.28 Typical High $134.90 | Facility | None | $36.31 | $81.28 | $134.90 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $138.04 | Professional | None | $39.81 | $44.67 | $138.04 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $316.23 | Professional | None | $158.49 | $158.49 | $316.23 |
Midlands Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $331.13 | Facility | None | $190.55 | $223.87 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $316.23 | Professional | None | $158.49 | $158.49 | $316.23 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $134.90 | Professional | None | $114.82 | $125.89 | $134.90 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
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 $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where Nebraska sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 29th of 51
$120
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.