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 $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $295.12 | Professional | None | $269.15 | $288.40 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $851.14 | Facility | None | $323.59 | $645.65 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $446.68 | Professional | None | $204.17 | $288.40 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $338.84 | Professional | None | $190.55 | $229.09 | $338.84 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $741.31 Typical High $3,235.94 | Facility | None | $275.42 | $741.31 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $1,023.29 | Professional | None | $245.47 | $426.58 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $446.68 | Professional | None | $380.19 | $446.68 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $851.14 | Facility | None | $323.59 | $645.65 | $851.14 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,698.24 Typical High $4,073.80 | Facility | None | $501.19 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $891.25 | Professional | None | $229.09 | $436.52 | $891.25 |
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 $141.25 Median $141.25 Typical High $147.91 | Professional | 52 · Reduced service | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | 53 · Discontinued | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | 54 · Surgery only | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $29.51 |
Where Iowa sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 15th of 51
$468
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.