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 $234.42 Median $1,148.15 Typical High $2,041.74 | Professional | None | $234.42 | $1,148.15 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $1,230.27 Typical High $3,162.28 | Professional | None | $426.58 | $1,230.27 | $3,162.28 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $1,258.93 Typical High $2,290.87 | Professional | None | $229.09 | $1,258.93 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $3,388.44 | Facility | None | $602.56 | $1,949.84 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $2,818.38 Typical High $9,332.54 | Professional | None | $575.44 | $2,818.38 | $9,332.54 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $2,398.83 Typical High $3,235.94 | Professional | None | $549.54 | $2,398.83 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $446.68 Median $2,290.87 Typical High $3,801.89 | Professional | None | $446.68 | $2,290.87 | $3,801.89 |
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 $269.15 Median $1,148.15 Typical High $3,467.37 | Professional | None | $269.15 | $1,148.15 | $3,467.37 |
Wellmark Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $3,801.89 | Professional | None | $467.74 | $575.44 | $3,801.89 |
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 $134.90 Median $575.44 Typical High $1,023.29 | Professional | 52 · Reduced service | $134.90 | $575.44 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $229.09 Typical High $416.87 | Professional | 53 · Discontinued | $54.95 | $229.09 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $870.96 Typical High $1,548.82 | Professional | 54 · Surgery only | $204.17 | $870.96 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $173.78 Typical High $309.03 | Professional | 55 · Aftercare only | $40.74 | $173.78 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $114.82 Typical High $204.17 | Professional | 56 · Pre-op care only | $27.54 | $114.82 | $204.17 |
Where Iowa sits
The same service costs 6.5 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
$1,778
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.