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 $50.12 Median $2,630.27 Typical High $6,760.83 | Facility | None | $50.12 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $38.02 Typical High $50.12 | Professional | None | $23.44 | $38.02 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $91.20 | Facility | None | $85.11 | $85.11 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $89.13 | Professional | None | $54.95 | $69.18 | $89.13 |
Hally Health Setting Professional Modifier None Typical Low $22.91 Median $39.81 Typical High $114.82 | Professional | None | $22.91 | $39.81 | $114.82 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $87.10 Typical High $1,380.38 | Facility | None | $45.71 | $87.10 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $67.61 Typical High $2,187.76 | Professional | None | $39.81 | $67.61 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $89.13 | Professional | None | $54.95 | $67.61 | $89.13 |
Midlands Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $97.72 | Facility | None | $85.11 | $91.20 | $97.72 |
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 $29.51 Median $48.98 Typical High $83.18 | Professional | None | $29.51 | $48.98 | $83.18 |
Wellmark Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $67.61 | Professional | None | $43.65 | $48.98 | $67.61 |
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 $11.75 Median $19.05 Typical High $25.12 | Professional | 52 · Reduced service | $11.75 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $7.59 Typical High $10.00 | Professional | 53 · Discontinued | $4.68 | $7.59 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $28.84 Typical High $37.15 | Professional | 54 · Surgery only | $17.78 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $5.75 Typical High $7.59 | Professional | 55 · Aftercare only | $3.55 | $5.75 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $3.80 Typical High $5.01 | Professional | 56 · Pre-op care only | $2.34 | $3.80 | $5.01 |
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· 3rd of 51
$63.10
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.