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 $27.54 Median $2,454.71 Typical High $6,760.83 | Facility | None | $27.54 | $2,454.71 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $30.90 Typical High $63.10 | Professional | None | $14.13 | $30.90 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $61.66 Typical High $89.13 | Professional | None | $32.36 | $61.66 | $89.13 |
Hally Health Setting Professional Modifier None Typical Low $13.49 Median $39.81 Typical High $57.54 | Professional | None | $13.49 | $39.81 | $57.54 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $87.10 Typical High $1,288.25 | Facility | None | $37.15 | $87.10 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $50.12 Typical High $125.89 | Professional | None | $31.62 | $50.12 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $32.36 Median $63.10 Typical High $89.13 | Professional | None | $32.36 | $63.10 | $89.13 |
Midlands Setting Facility Modifier None Typical Low $33.88 Median $36.31 Typical High $39.81 | Facility | None | $33.88 | $36.31 | $39.81 |
United Setting Facility Modifier None Typical Low $112.20 Median $575.44 Typical High $1,995.26 | Facility | None | $112.20 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $16.98 Median $37.15 Typical High $77.62 | Professional | None | $16.98 | $37.15 | $77.62 |
Wellmark Setting Professional Modifier None Typical Low $25.12 Median $28.18 Typical High $64.57 | Professional | None | $25.12 | $28.18 | $64.57 |
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 $7.08 Median $13.80 Typical High $31.62 | Professional | 52 · Reduced service | $7.08 | $13.80 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $5.50 Typical High $12.59 | Professional | 53 · Discontinued | $2.82 | $5.50 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $20.89 Typical High $46.77 | Professional | 54 · Surgery only | $10.47 | $20.89 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $4.17 Typical High $9.33 | Professional | 55 · Aftercare only | $2.09 | $4.17 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $2.75 Typical High $6.31 | Professional | 56 · Pre-op care only | $1.41 | $2.75 | $6.31 |
Where Iowa sits
The same service costs 3.5 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· 5th of 51
$47.86
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.