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 $398.11 Median $3,388.44 Typical High $6,760.83 | Facility | None | $398.11 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $398.11 | Professional | None | $141.25 | $229.09 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $380.19 Typical High $512.86 | Facility | None | $309.03 | $380.19 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $776.25 | Professional | None | $302.00 | $426.58 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $371.54 Typical High $660.69 | Professional | None | $123.03 | $371.54 | $660.69 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $562.34 Typical High $1,621.81 | Facility | None | $316.23 | $562.34 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $562.34 Typical High $2,089.30 | Professional | None | $295.12 | $562.34 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $602.56 Typical High $776.25 | Professional | None | $302.00 | $602.56 | $776.25 |
Midlands Setting Facility Modifier None Typical Low $302.00 Median $363.08 Typical High $512.86 | Facility | None | $302.00 | $363.08 | $512.86 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $851.14 | Professional | None | $295.12 | $416.87 | $851.14 |
United Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $691.83 | Professional | None | $151.36 | $316.23 | $691.83 |
Wellmark Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $660.69 | Professional | None | $239.88 | $281.84 | $660.69 |
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 $70.79 Median $114.82 Typical High $199.53 | Professional | 52 · Reduced service | $70.79 | $114.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $45.71 Typical High $79.43 | Professional | 53 · Discontinued | $28.18 | $45.71 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $173.78 Typical High $295.12 | Professional | 54 · Surgery only | $107.15 | $173.78 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $34.67 Typical High $58.88 | Professional | 55 · Aftercare only | $21.38 | $34.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.91 Typical High $39.81 | Professional | 56 · Pre-op care only | $14.13 | $22.91 | $39.81 |
Where Iowa sits
The same service costs 3.1 times more in Wisconsin 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· 7th of 51
$417
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.