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 $218.78 Median $2,630.27 Typical High $6,760.83 | Facility | None | $218.78 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $218.78 | Professional | None | $87.10 | $141.25 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $138.04 Typical High $173.78 | Facility | None | $117.49 | $138.04 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $371.54 | Professional | None | $204.17 | $288.40 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $181.97 Typical High $251.19 | Professional | None | $85.11 | $181.97 | $251.19 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $363.08 Typical High $2,137.96 | Facility | None | $169.82 | $363.08 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $676.08 | Professional | None | $173.78 | $251.19 | $676.08 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $371.54 | Professional | None | $204.17 | $275.42 | $371.54 |
Midlands Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $173.78 | Facility | None | $112.20 | $138.04 | $173.78 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $4,073.80 | Facility | None | $501.19 | $1,659.59 | $4,073.80 |
United Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $354.81 | Professional | None | $109.65 | $186.21 | $354.81 |
Wellmark Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $288.40 | Professional | None | $158.49 | $177.83 | $288.40 |
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 $43.65 Median $69.18 Typical High $109.65 | Professional | 52 · Reduced service | $43.65 | $69.18 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $28.18 Typical High $43.65 | Professional | 53 · Discontinued | $17.38 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $104.71 Typical High $162.18 | Professional | 54 · Surgery only | $64.57 | $104.71 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $20.89 Typical High $33.11 | Professional | 55 · Aftercare only | $12.88 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.13 Typical High $21.88 | Professional | 56 · Pre-op care only | $8.71 | $14.13 | $21.88 |
Where Iowa sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$234
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.