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 $457.09 Median $3,388.44 Typical High $6,760.83 | Facility | None | $457.09 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $457.09 | Professional | None | $169.82 | $288.40 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $1,659.59 | Facility | None | $645.65 | $1,380.38 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $870.96 | Professional | None | $363.08 | $512.86 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $426.58 Typical High $812.83 | Professional | None | $147.91 | $426.58 | $812.83 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $831.76 Typical High $4,677.35 | Facility | None | $426.58 | $831.76 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $660.69 Typical High $1,995.26 | Professional | None | $354.81 | $660.69 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $676.08 Typical High $870.96 | Professional | None | $363.08 | $676.08 | $870.96 |
Midlands Setting Facility Modifier None Typical Low $794.33 Median $1,380.38 Typical High $1,737.80 | Facility | None | $794.33 | $1,380.38 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $977.24 | Professional | None | $316.23 | $489.78 | $977.24 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,623.41 | Facility | None | $724.44 | $2,884.03 | $5,623.41 |
United Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $794.33 | Professional | None | $181.97 | $380.19 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $724.44 | Professional | None | $275.42 | $323.59 | $724.44 |
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 $85.11 Median $141.25 Typical High $229.09 | Professional | 52 · Reduced service | $85.11 | $141.25 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $57.54 Typical High $91.20 | Professional | 53 · Discontinued | $33.88 | $57.54 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $213.80 Typical High $338.84 | Professional | 54 · Surgery only | $128.82 | $213.80 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $42.66 Typical High $67.61 | Professional | 55 · Aftercare only | $25.70 | $42.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $28.18 Typical High $45.71 | Professional | 56 · Pre-op care only | $16.98 | $28.18 | $45.71 |
Where Iowa sits
The same service costs 3.9 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· 3rd of 51
$575
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.