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 $407.38 Median $2,630.27 Typical High $6,760.83 | Facility | None | $407.38 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $407.38 | Professional | None | $158.49 | $251.19 | $407.38 |
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 $363.08 Median $467.74 Typical High $616.60 | Professional | None | $363.08 | $467.74 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $338.84 Typical High $467.74 | Professional | None | $147.91 | $338.84 | $467.74 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $501.19 Typical High $1,288.25 | Facility | None | $245.47 | $501.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $1,862.09 | Professional | None | $275.42 | $467.74 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $588.84 | Professional | None | $309.03 | $501.19 | $588.84 |
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 $302.00 Median $478.63 Typical High $691.83 | Professional | None | $302.00 | $478.63 | $691.83 |
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 $173.78 Median $302.00 Typical High $575.44 | Professional | None | $173.78 | $302.00 | $575.44 |
Wellmark Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $691.83 | Professional | None | $316.23 | $371.54 | $691.83 |
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 $79.43 Median $125.89 Typical High $204.17 | Professional | 52 · Reduced service | $79.43 | $125.89 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $50.12 Typical High $81.28 | Professional | 53 · Discontinued | $31.62 | $50.12 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $186.21 Typical High $302.00 | Professional | 54 · Surgery only | $120.23 | $186.21 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $37.15 Typical High $60.26 | Professional | 55 · Aftercare only | $23.99 | $37.15 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $25.12 Typical High $40.74 | Professional | 56 · Pre-op care only | $15.85 | $25.12 | $40.74 |
Where Iowa sits
The same service costs 3.9 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
$398
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.