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 $117.49 Median $5,888.44 Typical High $7,943.28 | Facility | None | $117.49 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $117.49 | Professional | None | $67.61 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $602.56 Typical High $851.14 | Facility | None | $114.82 | $602.56 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $208.93 | Professional | None | $123.03 | $154.88 | $208.93 |
Hally Health Setting Professional Modifier None Typical Low $26.92 Median $45.71 Typical High $125.89 | Professional | None | $26.92 | $45.71 | $125.89 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $489.78 Typical High $1,778.28 | Facility | None | $97.72 | $489.78 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $229.09 | Professional | None | $72.44 | $125.89 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $194.98 | Professional | None | $128.82 | $154.88 | $194.98 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $602.56 Typical High $851.14 | Facility | None | $114.82 | $602.56 | $851.14 |
United Setting Facility Modifier None Typical Low $223.87 Median $1,096.48 Typical High $2,290.87 | Facility | None | $223.87 | $1,096.48 | $2,290.87 |
United Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $213.80 | Professional | None | $77.62 | $112.20 | $213.80 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | None | $89.13 | $93.33 | $93.33 |
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 $34.67 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $34.67 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $13.80 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $52.48 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $10.47 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.92 | $11.75 | $11.75 |
Where Iowa sits
The same service costs 5.5 times more in Arkansas 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· 9th of 51
$151
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.