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 $407.38 Median $4,168.69 Typical High $7,244.36 | Facility | None | $407.38 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $407.38 | Professional | None | $131.83 | $223.87 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $3,388.44 | Facility | None | $2,089.30 | $2,630.27 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $758.58 | Professional | None | $323.59 | $457.09 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $131.83 Median $323.59 Typical High $512.86 | Professional | None | $131.83 | $323.59 | $512.86 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $891.25 Typical High $8,511.38 | Facility | None | $316.23 | $891.25 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $1,174.90 | Professional | None | $316.23 | $537.03 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $758.58 | Professional | None | $323.59 | $467.74 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $1,584.89 Median $2,691.53 Typical High $3,388.44 | Facility | None | $1,584.89 | $2,691.53 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $870.96 | Professional | None | $281.84 | $436.52 | $870.96 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $10,471.29 | Facility | None | $1,380.38 | $4,365.16 | $10,471.29 |
United Setting Professional Modifier None Typical Low $165.96 Median $338.84 Typical High $676.08 | Professional | None | $165.96 | $338.84 | $676.08 |
Wellmark Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $645.65 | Professional | None | $234.42 | $275.42 | $645.65 |
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 $66.07 Median $109.65 Typical High $204.17 | Professional | 52 · Reduced service | $66.07 | $109.65 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $43.65 Typical High $81.28 | Professional | 53 · Discontinued | $26.30 | $43.65 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $162.18 Typical High $302.00 | Professional | 54 · Surgery only | $100.00 | $162.18 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $32.36 Typical High $60.26 | Professional | 55 · Aftercare only | $19.95 | $32.36 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $13.18 | $21.88 | $40.74 |
Where Iowa sits
The same service costs 5.8 times more in Alaska than in Hawaii. 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
$479
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.