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 $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $275.42 | Professional | None | $104.71 | $181.97 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $295.12 | Professional | None | $229.09 | $263.03 | $295.12 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $660.69 Typical High $1,288.25 | Professional | None | $151.36 | $660.69 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $1,621.81 | Facility | None | $181.97 | $302.00 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $1,621.81 | Professional | None | $134.90 | $239.88 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $295.12 | Professional | None | $223.87 | $263.03 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $831.76 | Professional | None | $213.80 | $281.84 | $831.76 |
United Setting Facility Modifier None Typical Low $158.49 Median $977.24 Typical High $2,344.23 | Facility | None | $158.49 | $977.24 | $2,344.23 |
United Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $323.59 | Professional | None | $117.49 | $177.83 | $323.59 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | None | $223.87 | $223.87 | $263.03 |
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 $52.48 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $52.48 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $20.89 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $79.43 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $15.85 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.47 | $18.20 | $18.20 |
Where Iowa sits
The same service costs 4.0 times more in Alaska than in Delaware. 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
$234
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.