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 $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,659.59 Typical High $3,090.30 | Professional | None | $398.11 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $5,011.87 | Professional | None | $645.65 | $1,096.48 | $5,011.87 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $1,905.46 Typical High $3,162.28 | Professional | None | $323.59 | $1,905.46 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $4,786.30 Typical High $13,489.63 | Facility | None | $933.25 | $4,786.30 | $13,489.63 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $4,786.30 Typical High $14,454.40 | Professional | None | $851.14 | $4,786.30 | $14,454.40 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $3,630.78 Typical High $5,011.87 | Professional | None | $776.25 | $3,630.78 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $4,365.16 Typical High $5,623.41 | Professional | None | $758.58 | $4,365.16 | $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 $416.87 Median $1,949.84 Typical High $6,025.60 | Professional | None | $416.87 | $1,949.84 | $6,025.60 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $4,677.35 | Professional | None | $630.96 | $776.25 | $4,677.35 |
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 $831.76 Typical High $1,548.82 | Professional | 52 · Reduced service | $199.53 | $831.76 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $331.13 Typical High $616.60 | Professional | 53 · Discontinued | $79.43 | $331.13 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $1,230.27 Typical High $2,344.23 | Professional | 54 · Surgery only | $295.12 | $1,230.27 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $245.47 Typical High $467.74 | Professional | 55 · Aftercare only | $60.26 | $245.47 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $165.96 Typical High $309.03 | Professional | 56 · Pre-op care only | $40.74 | $165.96 | $309.03 |
Where Iowa sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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· 2nd of 51
$3,090
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.