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 $134.90 Median $5,011.87 Typical High $7,943.28 | Facility | None | $134.90 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $190.55 | Professional | None | $95.50 | $134.90 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $562.34 Typical High $724.44 | Facility | None | $389.05 | $562.34 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $371.54 | Professional | None | $199.53 | $281.84 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $177.83 Typical High $389.05 | Professional | None | $83.18 | $177.83 | $389.05 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $457.09 Typical High $1,995.26 | Facility | None | $229.09 | $457.09 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $676.08 | Professional | None | $181.97 | $275.42 | $676.08 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $346.74 | Professional | None | $199.53 | $281.84 | $346.74 |
Midlands Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $724.44 | Facility | None | $389.05 | $549.54 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $389.05 | Professional | None | $199.53 | $269.15 | $389.05 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,621.81 Typical High $4,073.80 | Facility | None | $501.19 | $1,621.81 | $4,073.80 |
United Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $346.74 | Professional | None | $107.15 | $194.98 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $316.23 | Professional | None | $165.96 | $194.98 | $316.23 |
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 $47.86 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $47.86 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $26.92 Typical High $38.02 | Professional | 53 · Discontinued | $19.50 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $102.33 Typical High $141.25 | Professional | 54 · Surgery only | $72.44 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.42 Typical High $28.18 | Professional | 55 · Aftercare only | $14.45 | $20.42 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.55 | $13.49 | $19.05 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Indiana. 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
$269
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.