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 $147.91 Median $588.84 Typical High $6,309.57 | Facility | None | $147.91 | $588.84 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $162.18 Typical High $295.12 | Professional | None | $70.79 | $162.18 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $489.78 | Professional | None | $138.04 | $229.09 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $67.61 Median $263.03 Typical High $512.86 | Professional | None | $67.61 | $263.03 | $512.86 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $323.59 Typical High $1,621.81 | Facility | None | $181.97 | $323.59 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $446.68 Typical High $2,511.89 | Professional | None | $177.83 | $446.68 | $2,511.89 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $338.84 Typical High $489.78 | Professional | None | $141.25 | $338.84 | $489.78 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $537.03 | Professional | None | $141.25 | $204.17 | $537.03 |
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 $87.10 Median $204.17 Typical High $489.78 | Professional | None | $87.10 | $204.17 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $457.09 | Professional | None | $128.82 | $158.49 | $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 $35.48 Median $79.43 Typical High $147.91 | Professional | 52 · Reduced service | $35.48 | $79.43 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $31.62 Typical High $58.88 | Professional | 53 · Discontinued | $14.13 | $31.62 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $120.23 Typical High $223.87 | Professional | 54 · Surgery only | $53.70 | $120.23 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $23.99 Typical High $44.67 | Professional | 55 · Aftercare only | $10.72 | $23.99 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $15.85 Typical High $29.51 | Professional | 56 · Pre-op care only | $7.08 | $15.85 | $29.51 |
Where Iowa sits
The same service costs 3.8 times more in Alaska than in Virginia. 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
$282
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.