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 $281.84 Median $5,011.87 Typical High $7,943.28 | Facility | None | $281.84 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $478.63 | Professional | None | $177.83 | $281.84 | $478.63 |
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 $407.38 Median $478.63 Typical High $724.44 | Professional | None | $407.38 | $478.63 | $724.44 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $338.84 Typical High $537.03 | Professional | None | $165.96 | $338.84 | $537.03 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $489.78 Typical High $1,288.25 | Facility | None | $251.19 | $489.78 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $2,238.72 | Professional | None | $323.59 | $512.86 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $660.69 | Professional | None | $354.81 | $562.34 | $660.69 |
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 $338.84 Median $524.81 Typical High $812.83 | Professional | None | $338.84 | $524.81 | $812.83 |
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 $194.98 Median $331.13 Typical High $676.08 | Professional | None | $194.98 | $331.13 | $676.08 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $831.76 | Professional | None | $354.81 | $416.87 | $831.76 |
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 $89.13 Median $141.25 Typical High $239.88 | Professional | 52 · Reduced service | $89.13 | $141.25 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $56.23 Typical High $95.50 | Professional | 53 · Discontinued | $36.31 | $56.23 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $213.80 Typical High $363.08 | Professional | 54 · Surgery only | $134.90 | $213.80 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $42.66 Typical High $72.44 | Professional | 55 · Aftercare only | $26.92 | $42.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $28.18 Typical High $47.86 | Professional | 56 · Pre-op care only | $17.78 | $28.18 | $47.86 |
Where Iowa sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$427
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.