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 $316.23 Median $3,388.44 Typical High $6,760.83 | Facility | None | $316.23 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $316.23 | Professional | None | $138.04 | $199.53 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $3,311.31 | Facility | None | $954.99 | $2,630.27 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $602.56 | Professional | None | $288.40 | $467.74 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $120.23 Median $302.00 Typical High $524.81 | Professional | None | $120.23 | $302.00 | $524.81 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $1,047.13 Typical High $8,317.64 | Facility | None | $295.12 | $1,047.13 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $1,819.70 | Professional | None | $263.03 | $457.09 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $602.56 | Professional | None | $288.40 | $467.74 | $602.56 |
Midlands Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $3,311.31 | Facility | None | $1,513.56 | $2,570.40 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $676.08 | Professional | None | $257.04 | $389.05 | $676.08 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $9,772.37 | Facility | None | $1,258.93 | $3,630.78 | $9,772.37 |
United Setting Professional Modifier None Typical Low $147.91 Median $302.00 Typical High $562.34 | Professional | None | $147.91 | $302.00 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $512.86 | Professional | None | $223.87 | $263.03 | $512.86 |
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 $69.18 Median $97.72 Typical High $158.49 | Professional | 52 · Reduced service | $69.18 | $97.72 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $39.81 Typical High $63.10 | Professional | 53 · Discontinued | $27.54 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $147.91 Typical High $239.88 | Professional | 54 · Surgery only | $104.71 | $147.91 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $47.86 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.95 Typical High $31.62 | Professional | 56 · Pre-op care only | $13.80 | $19.95 | $31.62 |
Where Iowa sits
The same service costs 3.7 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
$407
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.