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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
BCBS Setting Facility Modifier None Typical Low $426.58 Median $501.19 Typical High $512.86 | Facility | None | $426.58 | $501.19 | $512.86 |
BCBS Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | None | $478.63 | $512.86 | $512.86 |
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 $575.44 Typical High $707.95 | Professional | None | $158.49 | $575.44 | $707.95 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $2,884.03 | Facility | None | $478.63 | $912.01 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $1,548.82 | Professional | None | $436.52 | $478.63 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $575.44 Typical High $707.95 | Professional | None | $158.49 | $575.44 | $707.95 |
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 $707.95 Typical High $912.01 | Professional | None | $316.23 | $707.95 | $912.01 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Where Nebraska sits
The same service costs 10.0 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· 7th of 51
$479
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.