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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | None | $15.85 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.94 Median $7.94 Typical High $8.71 | Professional | 52 · Reduced service | $7.94 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $3.47 | Professional | 53 · Discontinued | $3.16 | $3.16 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.57 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $30.90 | Professional | None | $9.55 | $9.55 | $30.90 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $30.20 Typical High $100.00 | Facility | None | $22.39 | $30.20 | $100.00 |
Medica Setting Professional Modifier None Typical Low $9.33 Median $9.77 Typical High $123.03 | Professional | None | $9.33 | $9.77 | $123.03 |
Oscar Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
United Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
United Setting Professional Modifier None Typical Low $7.59 Median $9.77 Typical High $15.85 | Professional | None | $7.59 | $9.77 | $15.85 |
2 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 |
|---|---|---|---|---|---|
Oscar Health Setting Professional Modifier MV Typical Low $25.12 Median $25.12 Typical High $64.57 | Professional | MV | $25.12 | $25.12 | $64.57 |
Oscar Health Setting Professional Modifier SV · Delivered, not used Typical Low $25.12 Median $25.12 Typical High $64.57 | Professional | SV · Delivered, not used | $25.12 | $25.12 | $64.57 |
Where Nebraska sits
The same service costs 3.0 times more in Montana 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· 48th of 51
$9.77
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.