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 $91.20 Median $2,630.27 Typical High $6,760.83 | Facility | None | $91.20 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $50.12 Typical High $91.20 | Professional | None | $26.30 | $50.12 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $63.10 Typical High $81.28 | Facility | None | $52.48 | $63.10 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $158.49 | Professional | None | $60.26 | $83.18 | $158.49 |
Hally Health Setting Professional Modifier None Typical Low $25.12 Median $70.79 Typical High $107.15 | Professional | None | $25.12 | $70.79 | $107.15 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $128.82 Typical High $1,621.81 | Facility | None | $69.18 | $128.82 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $223.87 | Professional | None | $58.88 | $85.11 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $154.88 | Professional | None | $60.26 | $112.20 | $154.88 |
Midlands Setting Facility Modifier None Typical Low $50.12 Median $63.10 Typical High $81.28 | Facility | None | $50.12 | $63.10 | $81.28 |
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 $33.11 Median $64.57 Typical High $134.90 | Professional | None | $33.11 | $64.57 | $134.90 |
Wellmark Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $117.49 | Professional | None | $47.86 | $53.70 | $117.49 |
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 $13.18 Median $20.89 Typical High $44.67 | Professional | 52 · Reduced service | $13.18 | $20.89 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.32 Typical High $18.20 | Professional | 53 · Discontinued | $5.25 | $8.32 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $31.62 Typical High $67.61 | Professional | 54 · Surgery only | $19.50 | $31.62 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $6.31 Typical High $13.49 | Professional | 55 · Aftercare only | $3.89 | $6.31 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.17 Typical High $9.12 | Professional | 56 · Pre-op care only | $2.63 | $4.17 | $9.12 |
Where Iowa sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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
$81.28
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.