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 $251.19 Median $5,011.87 Typical High $7,943.28 | Facility | None | $251.19 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $446.68 | Professional | None | $162.18 | $251.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $251.19 Typical High $323.59 | Facility | None | $181.97 | $251.19 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $676.08 | Professional | None | $269.15 | $478.63 | $676.08 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $346.74 Typical High $524.81 | Professional | None | $147.91 | $346.74 | $524.81 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $1,288.25 | Facility | None | $251.19 | $501.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $2,089.30 | Professional | None | $302.00 | $489.78 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $467.74 Typical High $616.60 | Professional | None | $229.09 | $467.74 | $616.60 |
Midlands Setting Facility Modifier None Typical Low $181.97 Median $245.47 Typical High $323.59 | Facility | None | $181.97 | $245.47 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $758.58 | Professional | None | $269.15 | $436.52 | $758.58 |
United Setting Facility Modifier None Typical Low $223.87 Median $758.58 Typical High $1,995.26 | Facility | None | $223.87 | $758.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $173.78 Median $309.03 Typical High $616.60 | Professional | None | $173.78 | $309.03 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $776.25 | Professional | None | $323.59 | $380.19 | $776.25 |
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 $79.43 Median $125.89 Typical High $223.87 | Professional | 52 · Reduced service | $79.43 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $50.12 Typical High $89.13 | Professional | 53 · Discontinued | $32.36 | $50.12 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $190.55 Typical High $338.84 | Professional | 54 · Surgery only | $120.23 | $190.55 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $38.02 Typical High $67.61 | Professional | 55 · Aftercare only | $23.99 | $38.02 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.12 Typical High $44.67 | Professional | 56 · Pre-op care only | $16.22 | $25.12 | $44.67 |
Where Iowa sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 5th of 51
$407
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.