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 $288.40 Median $3,388.44 Typical High $6,760.83 | Facility | None | $288.40 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $288.40 | Professional | None | $120.23 | $181.97 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $295.12 | Facility | None | $190.55 | $229.09 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $575.44 | Professional | None | $269.15 | $416.87 | $575.44 |
Hally Health Setting Professional Modifier None Typical Low $109.65 Median $275.42 Typical High $575.44 | Professional | None | $109.65 | $275.42 | $575.44 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $489.78 Typical High $1,348.96 | Facility | None | $204.17 | $489.78 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $1,621.81 | Professional | None | $263.03 | $416.87 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $549.54 | Professional | None | $269.15 | $416.87 | $549.54 |
Midlands Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $295.12 | Facility | None | $165.96 | $229.09 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $616.60 | Professional | None | $275.42 | $363.08 | $616.60 |
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 $138.04 Median $281.84 Typical High $537.03 | Professional | None | $138.04 | $281.84 | $537.03 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $457.09 | Professional | None | $208.93 | $245.47 | $457.09 |
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 $64.57 Median $91.20 Typical High $144.54 | Professional | 52 · Reduced service | $64.57 | $91.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $36.31 Typical High $57.54 | Professional | 53 · Discontinued | $26.30 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $134.90 Typical High $218.78 | Professional | 54 · Surgery only | $97.72 | $134.90 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $27.54 Typical High $43.65 | Professional | 55 · Aftercare only | $19.50 | $27.54 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.20 Typical High $28.84 | Professional | 56 · Pre-op care only | $12.88 | $18.20 | $28.84 |
Where Iowa sits
The same service costs 3.0 times more in Wisconsin 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· 4th of 51
$347
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.