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 $3,801.89 Typical High $6,760.83 | Facility | None | $676.08 | $3,801.89 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,584.89 Typical High $3,162.28 | Professional | None | $346.74 | $1,584.89 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,148.15 Typical High $4,897.79 | Professional | None | $575.44 | $1,148.15 | $4,897.79 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $1,905.46 Typical High $3,467.37 | Professional | None | $338.84 | $1,905.46 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $4,265.80 Typical High $13,489.63 | Facility | None | $933.25 | $4,265.80 | $13,489.63 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $4,073.80 Typical High $14,454.40 | Professional | None | $851.14 | $4,073.80 | $14,454.40 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $3,548.13 Typical High $4,897.79 | Professional | None | $831.76 | $3,548.13 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $3,388.44 Typical High $5,623.41 | Professional | None | $660.69 | $3,388.44 | $5,623.41 |
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 $1,698.24 Typical High $5,128.61 | Professional | None | $398.11 | $1,698.24 | $5,128.61 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $5,623.41 | Professional | None | $691.83 | $831.76 | $5,623.41 |
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 $199.53 Median $851.14 Typical High $1,584.89 | Professional | 52 · Reduced service | $199.53 | $851.14 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $338.84 Typical High $630.96 | Professional | 53 · Discontinued | $81.28 | $338.84 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,258.93 Typical High $2,344.23 | Professional | 54 · Surgery only | $302.00 | $1,258.93 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $257.04 Typical High $467.74 | Professional | 55 · Aftercare only | $60.26 | $257.04 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $169.82 Typical High $316.23 | Professional | 56 · Pre-op care only | $39.81 | $169.82 | $316.23 |
Where Iowa sits
The same service costs 6.2 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
$2,754
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.