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 $229.09 Median $5,011.87 Typical High $7,943.28 | Facility | None | $229.09 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $426.58 | Professional | None | $144.54 | $229.09 | $426.58 |
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 $245.47 Median $467.74 Typical High $645.65 | Professional | None | $245.47 | $467.74 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $131.83 Median $338.84 Typical High $478.63 | Professional | None | $131.83 | $338.84 | $478.63 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $489.78 Typical High $1,288.25 | Facility | None | $229.09 | $489.78 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $1,949.84 | Professional | None | $269.15 | $478.63 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $446.68 Typical High $575.44 | Professional | None | $208.93 | $446.68 | $575.44 |
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 $257.04 Median $501.19 Typical High $741.31 | Professional | None | $257.04 | $501.19 | $741.31 |
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 $154.88 Median $288.40 Typical High $588.84 | Professional | None | $154.88 | $288.40 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $741.31 | Professional | None | $288.40 | $338.84 | $741.31 |
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 $72.44 Median $114.82 Typical High $213.80 | Professional | 52 · Reduced service | $72.44 | $114.82 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $45.71 Typical High $85.11 | Professional | 53 · Discontinued | $28.84 | $45.71 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $169.82 Typical High $316.23 | Professional | 54 · Surgery only | $107.15 | $169.82 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $33.88 Typical High $63.10 | Professional | 55 · Aftercare only | $21.88 | $33.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $22.91 Typical High $42.66 | Professional | 56 · Pre-op care only | $14.45 | $22.91 | $42.66 |
Where Iowa sits
The same service costs 4.1 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· 5th of 51
$372
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.