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 $208.93 Median $2,238.72 Typical High $6,760.83 | Facility | None | $208.93 | $2,238.72 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $147.91 Typical High $295.12 | Professional | None | $64.57 | $147.91 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $478.63 | Professional | None | $128.82 | $204.17 | $478.63 |
Hally Health Setting Professional Modifier None Typical Low $61.66 Median $257.04 Typical High $478.63 | Professional | None | $61.66 | $257.04 | $478.63 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $416.87 Typical High $1,621.81 | Facility | None | $162.18 | $416.87 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $436.52 Typical High $2,691.53 | Professional | None | $162.18 | $436.52 | $2,691.53 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $331.13 Typical High $478.63 | Professional | None | $128.82 | $331.13 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $295.12 Typical High $524.81 | Professional | None | $128.82 | $295.12 | $524.81 |
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 $79.43 Median $194.98 Typical High $478.63 | Professional | None | $79.43 | $194.98 | $478.63 |
Wellmark Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $457.09 | Professional | None | $117.49 | $144.54 | $457.09 |
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 $72.44 Typical High $144.54 | Professional | 52 · Reduced service | $33.11 | $72.44 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $28.84 Typical High $58.88 | Professional | 53 · Discontinued | $13.18 | $28.84 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $109.65 Typical High $218.78 | Professional | 54 · Surgery only | $48.98 | $109.65 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $21.88 Typical High $43.65 | Professional | 55 · Aftercare only | $9.77 | $21.88 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $14.45 Typical High $29.51 | Professional | 56 · Pre-op care only | $6.61 | $14.45 | $29.51 |
Where Iowa sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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
$269
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.