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 $3,162.28 Typical High $6,760.83 | Facility | None | $602.56 | $3,162.28 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $1,479.11 Typical High $2,511.89 | Professional | None | $323.59 | $1,479.11 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,023.29 Typical High $3,890.45 | Professional | None | $512.86 | $1,023.29 | $3,890.45 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $1,548.82 Typical High $2,818.38 | Professional | None | $302.00 | $1,548.82 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $3,388.44 Typical High $8,511.38 | Facility | None | $831.76 | $3,388.44 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $3,388.44 Typical High $11,481.54 | Professional | None | $758.58 | $3,388.44 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $3,019.95 Typical High $4,168.69 | Professional | None | $724.44 | $3,019.95 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $3,019.95 Typical High $4,365.16 | Professional | None | $602.56 | $3,019.95 | $4,365.16 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $7,244.36 Typical High $10,232.93 | Facility | None | $4,677.35 | $7,244.36 | $10,232.93 |
United Setting Professional Modifier None Typical Low $354.81 Median $1,348.96 Typical High $4,168.69 | Professional | None | $354.81 | $1,348.96 | $4,168.69 |
Wellmark Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $4,365.16 | Professional | None | $616.60 | $758.58 | $4,365.16 |
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 $177.83 Median $758.58 Typical High $1,258.93 | Professional | 52 · Reduced service | $177.83 | $758.58 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $302.00 Typical High $501.19 | Professional | 53 · Discontinued | $70.79 | $302.00 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $1,122.02 Typical High $1,862.09 | Professional | 54 · Surgery only | $269.15 | $1,122.02 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $223.87 Typical High $380.19 | Professional | 55 · Aftercare only | $53.70 | $223.87 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $151.36 Typical High $251.19 | Professional | 56 · Pre-op care only | $35.48 | $151.36 | $251.19 |
Where Iowa sits
The same service costs 5.6 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· 3rd of 51
$2,291
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.