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 $3,548.13 Typical High $6,760.83 | Facility | None | $602.56 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $177.83 | Professional | None | $107.15 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $426.58 Typical High $891.25 | Facility | None | $363.08 | $426.58 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $288.40 | Professional | None | $120.23 | $218.78 | $288.40 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $549.54 | Professional | None | $100.00 | $165.96 | $549.54 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $416.87 Typical High $1,584.89 | Facility | None | $147.91 | $416.87 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $891.25 | Professional | None | $125.89 | $234.42 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $288.40 | Professional | None | $218.78 | $218.78 | $288.40 |
Midlands Setting Facility Modifier None Typical Low $295.12 Median $457.09 Typical High $954.99 | Facility | None | $295.12 | $457.09 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $288.40 | Professional | None | $190.55 | $223.87 | $288.40 |
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 $112.20 Median $158.49 Typical High $302.00 | Professional | None | $112.20 | $158.49 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | None | $181.97 | $181.97 | $218.78 |
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 $53.70 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $53.70 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $21.38 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $131.83 Typical High $131.83 | Professional | 54 · Surgery only | $81.28 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $16.22 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.72 | $17.78 | $17.78 |
Where Iowa sits
The same service costs 4.8 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
$219
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.