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 $275.42 Median $5,011.87 Typical High $7,943.28 | Facility | None | $275.42 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $478.63 | Professional | None | $173.78 | $275.42 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $251.19 Typical High $323.59 | Facility | None | $85.11 | $251.19 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $724.44 | Professional | None | $288.40 | $501.19 | $724.44 |
Hally Health Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $524.81 | Professional | None | $162.18 | $302.00 | $524.81 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $524.81 Typical High $1,288.25 | Facility | None | $251.19 | $524.81 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $2,238.72 | Professional | None | $309.03 | $524.81 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $501.19 Typical High $660.69 | Professional | None | $245.47 | $501.19 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $85.11 Median $245.47 Typical High $323.59 | Facility | None | $85.11 | $245.47 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $478.63 Typical High $812.83 | Professional | None | $288.40 | $478.63 | $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 $177.83 Median $323.59 Typical High $660.69 | Professional | None | $177.83 | $323.59 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $831.76 | Professional | None | $346.74 | $407.38 | $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 $87.10 Median $138.04 Typical High $239.88 | Professional | 52 · Reduced service | $87.10 | $138.04 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $54.95 Typical High $95.50 | Professional | 53 · Discontinued | $34.67 | $54.95 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $204.17 Typical High $363.08 | Professional | 54 · Surgery only | $128.82 | $204.17 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $40.74 Typical High $72.44 | Professional | 55 · Aftercare only | $26.30 | $40.74 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $27.54 Typical High $47.86 | Professional | 56 · Pre-op care only | $17.38 | $27.54 | $47.86 |
Where Iowa sits
The same service costs 4.0 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
$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.