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 $79.43 Median $5,011.87 Typical High $7,943.28 | Facility | None | $79.43 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $125.89 | Professional | None | $51.29 | $79.43 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $128.82 | Facility | None | $79.43 | $100.00 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $194.98 | Professional | None | $112.20 | $138.04 | $194.98 |
Hally Health Setting Professional Modifier None Typical Low $44.67 Median $100.00 Typical High $141.25 | Professional | None | $44.67 | $100.00 | $141.25 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $177.83 Typical High $1,288.25 | Facility | None | $107.15 | $177.83 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $588.84 | Professional | None | $87.10 | $144.54 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $177.83 | Professional | None | $95.50 | $147.91 | $177.83 |
Midlands Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $128.82 | Facility | None | $77.62 | $97.72 | $128.82 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $213.80 | Professional | None | $97.72 | $147.91 | $213.80 |
United Setting Facility Modifier None Typical Low $213.80 Median $575.44 Typical High $1,995.26 | Facility | None | $213.80 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $181.97 | Professional | None | $56.23 | $95.50 | $181.97 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $204.17 | Professional | None | $95.50 | $112.20 | $204.17 |
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 $25.70 Median $39.81 Typical High $63.10 | Professional | 52 · Reduced service | $25.70 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $15.85 Typical High $25.12 | Professional | 53 · Discontinued | $10.23 | $15.85 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $58.88 Typical High $95.50 | Professional | 54 · Surgery only | $38.02 | $58.88 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.02 Typical High $19.05 | Professional | 55 · Aftercare only | $7.59 | $12.02 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.94 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.13 | $7.94 | $12.59 |
Where Iowa sits
The same service costs 3.6 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
$126
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.