How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
BCBS Setting Facility Modifier None Typical Low $436.52 Median $512.86 Typical High $524.81 | Facility | None | $436.52 | $512.86 | $524.81 |
BCBS Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | None | $501.19 | $524.81 | $524.81 |
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 $158.49 Median $398.11 Typical High $602.56 | Professional | None | $158.49 | $398.11 | $602.56 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $630.96 Typical High $3,162.28 | Facility | None | $107.15 | $630.96 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $1,659.59 | Professional | None | $331.13 | $331.13 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $398.11 Typical High $602.56 | Professional | None | $158.49 | $398.11 | $602.56 |
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 $316.23 Median $602.56 Typical High $776.25 | Professional | None | $316.23 | $602.56 | $776.25 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $134.90 | Professional | None | $114.82 | $125.89 | $134.90 |
4 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 $229.09 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
Where Nebraska sits
The same service costs 12.0 times more in Wyoming than in North Carolina. 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· 16th of 51
$398
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.