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 $3,548.13 Typical High $6,760.83 | Facility | None | $602.56 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $416.87 | Professional | None | $354.81 | $380.19 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,981.07 Typical High $5,011.87 | Facility | None | $3,548.13 | $3,981.07 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | None | $467.74 | $467.74 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $186.21 | Professional | None | $141.25 | $158.49 | $186.21 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $3,890.45 Typical High $9,549.93 | Facility | None | $562.34 | $3,890.45 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $630.96 Typical High $2,570.40 | Professional | None | $380.19 | $630.96 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $1,047.13 | Professional | None | $478.63 | $501.19 | $1,047.13 |
Midlands Setting Facility Modifier None Typical Low $2,630.27 Median $3,981.07 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,981.07 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $1,000.00 | Professional | None | $363.08 | $549.54 | $1,000.00 |
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 $177.83 Median $190.55 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $269.15 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $38.90 |
Where Iowa sits
The same service costs 28.2 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· 17th of 51
$631
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.