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 $1,380.38 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,380.38 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,380.38 Typical High $1,380.38 | Professional | None | $758.58 | $1,380.38 | $1,380.38 |
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 $1,230.27 Median $1,318.26 Typical High $4,365.16 | Professional | None | $1,230.27 | $1,318.26 | $4,365.16 |
Hally Health Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $3,715.35 | Professional | None | $537.03 | $851.14 | $3,715.35 |
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 $1,202.26 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,202.26 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
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 $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Where Iowa sits
The same service costs 67.6 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
$3,090
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.