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 $380.19 Median $2,818.38 Typical High $6,606.93 | Facility | None | $380.19 | $2,818.38 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $630.96 | Professional | None | $177.83 | $316.23 | $630.96 |
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 $380.19 Median $524.81 Typical High $691.83 | Professional | None | $380.19 | $524.81 | $691.83 |
Hally Health Setting Professional Modifier None Typical Low $154.88 Median $380.19 Typical High $812.83 | Professional | None | $154.88 | $380.19 | $812.83 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $707.95 Typical High $5,128.61 | Facility | None | $446.68 | $707.95 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $2,187.76 | Professional | None | $363.08 | $562.34 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $691.83 | Professional | None | $380.19 | $575.44 | $691.83 |
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 $389.05 Median $512.86 Typical High $776.25 | Professional | None | $389.05 | $512.86 | $776.25 |
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 $194.98 Median $389.05 Typical High $776.25 | Professional | None | $194.98 | $389.05 | $776.25 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $616.60 | Professional | None | $288.40 | $338.84 | $616.60 |
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 $91.20 Median $123.03 Typical High $190.55 | Professional | 52 · Reduced service | $91.20 | $123.03 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $50.12 Typical High $75.86 | Professional | 53 · Discontinued | $36.31 | $50.12 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $281.84 | Professional | 54 · Surgery only | $134.90 | $186.21 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $57.54 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $24.55 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.20 | $24.55 | $38.02 |
Where Iowa sits
The same service costs 3.1 times more in Alaska than in New York. 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
$525
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.