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 $295.12 Median $5,011.87 Typical High $7,943.28 | Facility | None | $295.12 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $512.86 | Professional | None | $186.21 | $295.12 | $512.86 |
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 $316.23 Median $512.86 Typical High $794.33 | Professional | None | $316.23 | $512.86 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $173.78 Median $363.08 Typical High $575.44 | Professional | None | $173.78 | $363.08 | $575.44 |
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 $346.74 Median $537.03 Typical High $2,398.83 | Professional | None | $346.74 | $537.03 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $537.03 Typical High $707.95 | Professional | None | $263.03 | $537.03 | $707.95 |
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 $331.13 Median $512.86 Typical High $870.96 | Professional | None | $331.13 | $512.86 | $870.96 |
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 $204.17 Median $354.81 Typical High $707.95 | Professional | None | $204.17 | $354.81 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $891.25 | Professional | None | $371.54 | $436.52 | $891.25 |
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 $93.33 Median $147.91 Typical High $257.04 | Professional | 52 · Reduced service | $93.33 | $147.91 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $58.88 Typical High $102.33 | Professional | 53 · Discontinued | $38.02 | $58.88 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $223.87 Typical High $389.05 | Professional | 54 · Surgery only | $141.25 | $223.87 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $44.67 Typical High $77.62 | Professional | 55 · Aftercare only | $28.18 | $44.67 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $29.51 Typical High $51.29 | Professional | 56 · Pre-op care only | $18.62 | $29.51 | $51.29 |
Where Iowa sits
The same service costs 3.8 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
$457
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.