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 $602.56 Median $4,265.80 Typical High $7,244.36 | Facility | None | $602.56 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $660.69 | Professional | None | $512.86 | $512.86 | $660.69 |
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 $1,318.26 Median $1,445.44 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,445.44 | $3,890.45 |
Hally Health Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $2,691.53 | Professional | None | $537.03 | $851.14 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $3,890.45 Typical High $10,232.93 | Facility | None | $1,096.48 | $3,890.45 | $10,232.93 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,412.54 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 |
Wellmark Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Where Iowa sits
The same service costs 74.1 times more in Oklahoma than in Montana. 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· 6th of 51
$2,951
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.