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 $128.82 Median $194.98 Typical High $194.98 | Professional | None | $128.82 | $194.98 | $194.98 |
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 $147.91 Median $275.42 Typical High $338.84 | Professional | None | $147.91 | $275.42 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $501.19 | Professional | None | $114.82 | $208.93 | $501.19 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $416.87 Typical High $1,348.96 | Facility | None | $218.78 | $416.87 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $1,737.80 | Professional | None | $151.36 | $269.15 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $338.84 | Professional | None | $269.15 | $275.42 | $338.84 |
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 $218.78 Median $269.15 Typical High $338.84 | Professional | None | $218.78 | $269.15 | $338.84 |
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 $131.83 Median $190.55 Typical High $338.84 | Professional | None | $131.83 | $190.55 | $338.84 |
Wellmark Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | None | $239.88 | $239.88 | $281.84 |
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 $64.57 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $64.57 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $25.70 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $147.91 Typical High $147.91 | Professional | 54 · Surgery only | $95.50 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $19.05 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.88 | $19.50 | $19.50 |
Where Iowa sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 5th of 51
$269
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.