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 $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $81.28 | Professional | None | $52.48 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $398.11 Typical High $512.86 | Facility | None | $245.47 | $398.11 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $141.25 | Professional | None | $61.66 | $104.71 | $141.25 |
Hally Health Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $213.80 | Professional | None | $45.71 | $87.10 | $213.80 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $416.87 Typical High $1,348.96 | Facility | None | $77.62 | $416.87 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $107.15 Typical High $478.63 | Professional | None | $63.10 | $107.15 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $138.04 | Professional | None | $104.71 | $104.71 | $138.04 |
Midlands Setting Facility Modifier None Typical Low $245.47 Median $398.11 Typical High $512.86 | Facility | None | $245.47 | $398.11 | $512.86 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $138.04 | Professional | None | $107.15 | $109.65 | $138.04 |
United Setting Facility Modifier None Typical Low $223.87 Median $977.24 Typical High $1,995.26 | Facility | None | $223.87 | $977.24 | $1,995.26 |
United Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $144.54 | Professional | None | $52.48 | $77.62 | $144.54 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | None | $87.10 | $87.10 | $102.33 |
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 $26.30 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $26.30 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $10.47 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $61.66 Typical High $61.66 | Professional | 54 · Surgery only | $39.81 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $7.94 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.25 | $8.13 | $8.13 |
Where Iowa sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 6th of 51
$102
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.