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 $3,467.37 Median $4,265.80 Typical High $7,244.36 | Facility | None | $3,467.37 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,137.96 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $3,235.94 Typical High $4,073.80 | Facility | None | $1,096.48 | $3,235.94 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $4,365.16 Median $4,677.35 Typical High $6,760.83 | Professional | None | $4,365.16 | $4,677.35 | $6,760.83 |
Hally Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $3,715.35 | Professional | None | $1,174.90 | $1,949.84 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,659.59 | $4,365.16 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $2,630.27 Median $4,365.16 Typical High $7,244.36 | Professional | None | $2,630.27 | $4,365.16 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $5,888.44 | Professional | None | $4,466.84 | $4,677.35 | $5,888.44 |
Midlands Setting Facility Modifier None Typical Low $1,513.56 Median $3,090.30 Typical High $4,073.80 | Facility | None | $1,513.56 | $3,090.30 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $10,000.00 | Facility | None | $1,380.38 | $4,365.16 | $10,000.00 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $3,467.37 Typical High $6,606.93 | Professional | None | $2,454.71 | $3,467.37 | $6,606.93 |
Wellmark Setting Professional Modifier None Typical Low $3,019.95 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,019.95 | $3,162.28 | $3,162.28 |
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 $1,047.13 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,047.13 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $426.58 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,584.89 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $316.23 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $213.80 | $354.81 | $354.81 |
Where Iowa sits
The same service costs 7.1 times more in Alaska than in Kentucky. 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· 8th of 51
$3,802
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.