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 $93.33 Median $2,630.27 Typical High $6,760.83 | Facility | None | $93.33 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $52.48 Typical High $93.33 | Professional | None | $26.92 | $52.48 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $79.43 | Facility | None | $74.13 | $74.13 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $169.82 | Professional | None | $63.10 | $89.13 | $169.82 |
Hally Health Setting Professional Modifier None Typical Low $26.30 Median $81.28 Typical High $104.71 | Professional | None | $26.30 | $81.28 | $104.71 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $147.91 Typical High $1,380.38 | Facility | None | $69.18 | $147.91 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $93.33 Typical High $1,230.27 | Professional | None | $53.70 | $93.33 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $162.18 | Professional | None | $63.10 | $117.49 | $162.18 |
Midlands Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $87.10 | Facility | None | $74.13 | $79.43 | $87.10 |
United Setting Facility Modifier None Typical Low $158.49 Median $954.99 Typical High $1,995.26 | Facility | None | $158.49 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $33.88 Median $70.79 Typical High $151.36 | Professional | None | $33.88 | $70.79 | $151.36 |
Wellmark Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $131.83 | Professional | None | $47.86 | $53.70 | $131.83 |
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 $13.49 Median $21.38 Typical High $46.77 | Professional | 52 · Reduced service | $13.49 | $21.38 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $8.51 Typical High $18.62 | Professional | 53 · Discontinued | $5.37 | $8.51 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $32.36 Typical High $69.18 | Professional | 54 · Surgery only | $20.42 | $32.36 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $6.46 Typical High $13.80 | Professional | 55 · Aftercare only | $4.07 | $6.46 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $4.27 Typical High $9.33 | Professional | 56 · Pre-op care only | $2.69 | $4.27 | $9.33 |
Where Iowa sits
The same service costs 4.0 times more in Alaska than in Texas. 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
$89.13
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.