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 $1,047.13 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,047.13 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,047.13 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $7,079.46 Median $7,762.47 Typical High $9,772.37 | Facility | None | $7,079.46 | $7,762.47 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,659.59 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $5,754.40 Typical High $17,378.01 | Facility | None | $1,380.38 | $5,754.40 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $8,709.64 | Professional | None | $1,348.96 | $1,905.46 | $8,709.64 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,659.59 | $1,659.59 |
Midlands Setting Facility Modifier None Typical Low $5,888.44 Median $7,762.47 Typical High $9,772.37 | Facility | None | $5,888.44 | $7,762.47 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $4,466.84 | Professional | None | $1,318.26 | $1,318.26 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,230.27 | $1,862.09 | $3,388.44 |
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 $501.19 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $218.78 | Professional | 53 · Discontinued | $199.53 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $741.31 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $109.65 |
Where Iowa sits
The same service costs 5.9 times more in Texas 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· 28th of 51
$1,778
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.