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 $151.36 Median $2,630.27 Typical High $6,760.83 | Facility | None | $151.36 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $173.78 | Professional | None | $51.29 | $93.33 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $120.23 Typical High $147.91 | Facility | None | $95.50 | $120.23 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $275.42 | Professional | None | $123.03 | $173.78 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $51.29 Median $141.25 Typical High $295.12 | Professional | None | $51.29 | $141.25 | $295.12 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $257.04 Typical High $1,288.25 | Facility | None | $120.23 | $257.04 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $457.09 | Professional | None | $120.23 | $218.78 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $263.03 | Professional | None | $123.03 | $223.87 | $263.03 |
Midlands Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $147.91 | Facility | None | $87.10 | $120.23 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $316.23 | Professional | None | $134.90 | $165.96 | $316.23 |
United Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $66.07 Median $138.04 Typical High $309.03 | Professional | None | $66.07 | $138.04 | $309.03 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $223.87 | Professional | None | $87.10 | $102.33 | $223.87 |
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 $25.70 Median $41.69 Typical High $75.86 | Professional | 52 · Reduced service | $25.70 | $41.69 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $16.98 Typical High $30.90 | Professional | 53 · Discontinued | $10.23 | $16.98 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $63.10 Typical High $114.82 | Professional | 54 · Surgery only | $38.02 | $63.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $12.59 Typical High $22.91 | Professional | 55 · Aftercare only | $7.76 | $12.59 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.51 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.13 | $8.51 | $15.14 |
Where Iowa sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 4th of 51
$178
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.