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 $14.79 Median $41.69 Typical High $50.12 | Facility | None | $14.79 | $41.69 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $9.12 Median $25.70 Typical High $50.12 | Professional | None | $9.12 | $25.70 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $53.70 Typical High $93.33 | Professional | None | $20.89 | $53.70 | $93.33 |
Hally Health Setting Professional Modifier None Typical Low $8.32 Median $42.66 Typical High $72.44 | Professional | None | $8.32 | $42.66 | $72.44 |
Medica Setting Facility Modifier None Typical Low $23.99 Median $67.61 Typical High $1,348.96 | Facility | None | $23.99 | $67.61 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $23.44 Median $58.88 Typical High $181.97 | Professional | None | $23.44 | $58.88 | $181.97 |
Midlands Setting Professional Modifier None Typical Low $20.89 Median $66.07 Typical High $83.18 | Professional | None | $20.89 | $66.07 | $83.18 |
Midlands Setting Professional Modifier None Typical Low $18.20 Median $26.92 Typical High $93.33 | Professional | None | $18.20 | $26.92 | $93.33 |
United Setting Facility Modifier None Typical Low $158.49 Median $954.99 Typical High $1,995.26 | Facility | None | $158.49 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $10.72 Median $29.51 Typical High $74.13 | Professional | None | $10.72 | $29.51 | $74.13 |
Wellmark Setting Professional Modifier None Typical Low $16.60 Median $19.50 Typical High $77.62 | Professional | None | $16.60 | $19.50 | $77.62 |
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 $5.50 Median $7.41 Typical High $25.12 | Professional | 52 · Reduced service | $5.50 | $7.41 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.95 Typical High $10.00 | Professional | 53 · Discontinued | $2.19 | $2.95 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $11.22 Typical High $38.02 | Professional | 54 · Surgery only | $8.32 | $11.22 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.24 Typical High $7.59 | Professional | 55 · Aftercare only | $1.66 | $2.24 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.48 Typical High $5.01 | Professional | 56 · Pre-op care only | $1.12 | $1.48 | $5.01 |
Where Iowa sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 5th of 51
$47.86
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.