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 $1,288.25 Median $3,548.13 Typical High $6,760.83 | Facility | None | $1,288.25 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $19,498.45 Median $23,988.33 Typical High $45,708.82 | Facility | None | $19,498.45 | $23,988.33 | $45,708.82 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $3,388.44 | Professional | None | $1,698.24 | $2,818.38 | $3,388.44 |
Hally Health Setting Professional Modifier None Typical Low $851.14 Median $2,187.76 Typical High $2,951.21 | Professional | None | $851.14 | $2,187.76 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $2,691.53 Median $9,549.93 Typical High $41,686.94 | Facility | None | $2,691.53 | $9,549.93 | $41,686.94 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $3,311.31 Typical High $10,715.19 | Professional | None | $1,584.89 | $3,311.31 | $10,715.19 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $3,388.44 | Professional | None | $1,584.89 | $3,388.44 | $3,388.44 |
Midlands Setting Facility Modifier None Typical Low $18,197.01 Median $23,988.33 Typical High $41,686.94 | Facility | None | $18,197.01 | $23,988.33 | $41,686.94 |
Midlands Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
United Setting Facility Modifier None Typical Low $3,548.13 Median $14,454.40 Typical High $43,651.58 | Facility | None | $3,548.13 | $14,454.40 | $43,651.58 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $4,265.80 | Professional | None | $1,584.89 | $2,187.76 | $4,265.80 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
Where Iowa sits
The same service costs 6.9 times more in Arkansas than in Kentucky. 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.
Iowa· 8th of 51
$3,311
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.