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 $602.56 Median $4,265.80 Typical High $7,244.36 | Facility | None | $602.56 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $213.80 | Professional | None | $141.25 | $141.25 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $346.74 | Professional | None | $181.97 | $316.23 | $346.74 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $245.47 | Professional | None | $186.21 | $204.17 | $245.47 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $489.78 Typical High $1,621.81 | Facility | None | $158.49 | $489.78 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $602.56 Typical High $1,318.26 | Professional | None | $302.00 | $602.56 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $316.23 | Professional | None | $190.55 | $316.23 | $316.23 |
United Setting Facility Modifier None Typical Low $158.49 Median $954.99 Typical High $1,995.26 | Facility | None | $158.49 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $1,071.52 | Professional | None | $288.40 | $602.56 | $1,071.52 |
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 $70.79 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $70.79 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | 53 · Discontinued | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | 54 · Surgery only | $107.15 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.79 |
Where Iowa sits
The same service costs 18.6 times more in Texas 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.
Iowa· 4th of 51
$575
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.