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 $676.08 Median $3,981.07 Typical High $6,760.83 | Facility | None | $676.08 | $3,981.07 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,584.89 Typical High $3,235.94 | Professional | None | $346.74 | $1,584.89 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,148.15 Typical High $5,128.61 | Professional | None | $588.84 | $1,148.15 | $5,128.61 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $1,949.84 Typical High $3,548.13 | Professional | None | $338.84 | $1,949.84 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $13,489.63 | Facility | None | $851.14 | $4,466.84 | $13,489.63 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $4,168.69 Typical High $14,791.08 | Professional | None | $851.14 | $4,168.69 | $14,791.08 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $3,467.37 Typical High $5,128.61 | Professional | None | $707.95 | $3,467.37 | $5,128.61 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $3,311.31 Typical High $5,754.40 | Professional | None | $660.69 | $3,311.31 | $5,754.40 |
United Setting Facility Modifier None Typical Low $7,244.36 Median $10,715.19 Typical High $15,488.17 | Facility | None | $7,244.36 | $10,715.19 | $15,488.17 |
United Setting Professional Modifier None Typical Low $398.11 Median $1,819.70 Typical High $5,495.41 | Professional | None | $398.11 | $1,819.70 | $5,495.41 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $5,754.40 | Professional | None | $691.83 | $851.14 | $5,754.40 |
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 $204.17 Median $851.14 Typical High $1,621.81 | Professional | 52 · Reduced service | $204.17 | $851.14 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $338.84 Typical High $645.65 | Professional | 53 · Discontinued | $81.28 | $338.84 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,288.25 Typical High $2,398.83 | Professional | 54 · Surgery only | $302.00 | $1,288.25 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $257.04 Typical High $478.63 | Professional | 55 · Aftercare only | $60.26 | $257.04 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $169.82 Typical High $323.59 | Professional | 56 · Pre-op care only | $40.74 | $169.82 | $323.59 |
Where Iowa sits
The same service costs 6.3 times more in Washington 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· 3rd of 51
$2,818
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.