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 $89.13 Median $2,630.27 Typical High $6,760.83 | Facility | None | $89.13 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $91.20 | Professional | None | $60.26 | $83.18 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $112.20 Typical High $186.21 | Facility | None | $87.10 | $112.20 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $151.36 | Professional | None | $72.44 | $138.04 | $151.36 |
Hally Health Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $154.88 | Professional | None | $69.18 | $112.20 | $154.88 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $295.12 Typical High $1,380.38 | Facility | None | $93.33 | $295.12 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $162.18 Typical High $501.19 | Professional | None | $89.13 | $162.18 | $501.19 |
Midlands Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $138.04 | Professional | None | $69.18 | $100.00 | $138.04 |
Midlands Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $181.97 | Facility | None | $87.10 | $107.15 | $181.97 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $257.04 | Professional | None | $81.28 | $141.25 | $257.04 |
Wellmark Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $138.04 | Professional | None | $77.62 | $77.62 | $138.04 |
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 $30.20 Median $33.11 Typical High $45.71 | Professional | 52 · Reduced service | $30.20 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.18 Typical High $18.20 | Professional | 53 · Discontinued | $12.02 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $46.77 Typical High $67.61 | Professional | 54 · Surgery only | $45.71 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.00 Typical High $13.80 | Professional | 55 · Aftercare only | $9.12 | $10.00 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.61 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.03 | $6.61 | $9.12 |
Where Iowa sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 12th of 51
$138
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.