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 $79.43 Median $5,011.87 Typical High $7,943.28 | Facility | None | $79.43 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $125.89 | Professional | None | $48.98 | $79.43 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $93.33 Typical High $117.49 | Facility | None | $69.18 | $93.33 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $223.87 | Professional | None | $114.82 | $165.96 | $223.87 |
Hally Health Setting Professional Modifier None Typical Low $47.86 Median $104.71 Typical High $141.25 | Professional | None | $47.86 | $104.71 | $141.25 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $177.83 Typical High $1,288.25 | Facility | None | $93.33 | $177.83 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $549.54 | Professional | None | $89.13 | $138.04 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $204.17 | Professional | None | $114.82 | $144.54 | $204.17 |
Midlands Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $117.49 | Facility | None | $56.23 | $91.20 | $117.49 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $186.21 | Professional | None | $60.26 | $97.72 | $186.21 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $173.78 | Professional | None | $89.13 | $97.72 | $173.78 |
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 $24.55 Median $39.81 Typical High $63.10 | Professional | 52 · Reduced service | $24.55 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $15.85 Typical High $25.12 | Professional | 53 · Discontinued | $10.00 | $15.85 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $58.88 Typical High $93.33 | Professional | 54 · Surgery only | $37.15 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $11.75 Typical High $18.62 | Professional | 55 · Aftercare only | $7.41 | $11.75 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.94 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.90 | $7.94 | $12.59 |
Where Iowa sits
The same service costs 3.4 times more in Alaska than in New York. 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
$126
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.