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 $602.56 Median $2,630.27 Typical High $6,760.83 | Facility | None | $602.56 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $512.86 Typical High $851.14 | Professional | None | $173.78 | $512.86 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $1,412.54 | Professional | None | $302.00 | $467.74 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $141.25 Median $724.44 Typical High $1,174.90 | Professional | None | $141.25 | $724.44 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $1,148.15 Typical High $1,621.81 | Facility | None | $389.05 | $1,148.15 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,148.15 Typical High $3,890.45 | Professional | None | $323.59 | $1,148.15 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $1,000.00 Typical High $1,318.26 | Professional | None | $331.13 | $1,000.00 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $1,000.00 Typical High $1,548.82 | Professional | None | $302.00 | $1,000.00 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,630.78 | Facility | None | $1,096.48 | $1,737.80 | $3,630.78 |
United Setting Professional Modifier None Typical Low $173.78 Median $524.81 Typical High $1,380.38 | Professional | None | $173.78 | $524.81 | $1,380.38 |
Wellmark Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $1,258.93 | Professional | None | $281.84 | $338.84 | $1,258.93 |
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 $87.10 Median $251.19 Typical High $416.87 | Professional | 52 · Reduced service | $87.10 | $251.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $102.33 Typical High $169.82 | Professional | 53 · Discontinued | $34.67 | $102.33 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $380.19 Typical High $630.96 | Professional | 54 · Surgery only | $128.82 | $380.19 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $75.86 Typical High $125.89 | Professional | 55 · Aftercare only | $25.70 | $75.86 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $51.29 Typical High $85.11 | Professional | 56 · Pre-op care only | $17.38 | $51.29 | $85.11 |
Where Iowa sits
The same service costs 3.5 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· 4th of 51
$741
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.