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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | None | $64.57 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $10.00 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $131.83 | Professional | None | $37.15 | $37.15 | $131.83 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $123.03 Typical High $407.38 | Facility | None | $85.11 | $123.03 | $407.38 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $39.81 Typical High $489.78 | Professional | None | $37.15 | $39.81 | $489.78 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $39.81 | Professional | None | $30.20 | $39.81 | $39.81 |
1 more rate 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 |
|---|---|---|---|---|---|
Oscar Health Setting Professional Modifier PR · Ambulance P to R Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | PR · Ambulance P to R | $15.14 | $15.14 | $15.14 |
Where Nebraska sits
The same service costs 3.6 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· 46th of 51
$39.81
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.