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 $707.95 Median $4,265.80 Typical High $7,244.36 | Facility | None | $707.95 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | None | $707.95 | $707.95 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $6,606.93 Typical High $8,511.38 | Facility | None | $5,248.07 | $6,606.93 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,348.96 | Professional | None | $933.25 | $1,288.25 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $1,380.38 | Professional | None | $501.19 | $870.96 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $4,677.35 Typical High $12,882.50 | Facility | None | $1,202.26 | $4,677.35 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $5,754.40 | Professional | None | $794.33 | $1,288.25 | $5,754.40 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $933.25 | $1,288.25 | $1,288.25 |
Midlands Setting Facility Modifier None Typical Low $3,981.07 Median $6,606.93 Typical High $8,511.38 | Facility | None | $3,981.07 | $6,606.93 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,584.89 | $5,011.87 | $14,125.38 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $2,041.74 | Professional | None | $724.44 | $1,047.13 | $2,041.74 |
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 $346.74 Median $346.74 Typical High $354.81 | Professional | 52 · Reduced service | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $70.79 |
Where Iowa sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 19th of 51
$1,288
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.