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 $245.47 Median $2,630.27 Typical High $6,760.83 | Facility | None | $245.47 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $245.47 | Professional | None | $67.61 | $138.04 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $416.87 | Professional | None | $147.91 | $223.87 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $69.18 Median $223.87 Typical High $467.74 | Professional | None | $69.18 | $223.87 | $467.74 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $1,621.81 | Facility | None | $194.98 | $309.03 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $354.81 Typical High $1,737.80 | Professional | None | $173.78 | $354.81 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $416.87 | Professional | None | $165.96 | $309.03 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $457.09 | Professional | None | $147.91 | $213.80 | $457.09 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,630.78 | Facility | None | $1,096.48 | $1,737.80 | $3,630.78 |
United Setting Professional Modifier None Typical Low $91.20 Median $190.55 Typical High $416.87 | Professional | None | $91.20 | $190.55 | $416.87 |
Wellmark Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $354.81 | Professional | None | $120.23 | $147.91 | $354.81 |
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 $33.11 Median $66.07 Typical High $123.03 | Professional | 52 · Reduced service | $33.11 | $66.07 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $26.30 Typical High $48.98 | Professional | 53 · Discontinued | $13.49 | $26.30 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $100.00 Typical High $186.21 | Professional | 54 · Surgery only | $50.12 | $100.00 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $19.95 Typical High $37.15 | Professional | 55 · Aftercare only | $10.00 | $19.95 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $13.18 Typical High $24.55 | Professional | 56 · Pre-op care only | $6.76 | $13.18 | $24.55 |
Where Iowa sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 4th of 51
$245
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.