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 $588.84 Median $2,630.27 Typical High $6,760.83 | Facility | None | $588.84 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $354.81 Typical High $588.84 | Professional | None | $87.10 | $354.81 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $588.84 Typical High $724.44 | Facility | None | $512.86 | $588.84 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $1,047.13 | Professional | None | $181.97 | $251.19 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $426.58 Typical High $1,548.82 | Professional | None | $85.11 | $426.58 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $741.31 Typical High $2,089.30 | Facility | None | $213.80 | $741.31 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $891.25 Typical High $1,548.82 | Professional | None | $213.80 | $891.25 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $812.83 Typical High $1,047.13 | Professional | None | $177.83 | $812.83 | $1,047.13 |
Midlands Setting Facility Modifier None Typical Low $416.87 Median $575.44 Typical High $724.44 | Facility | None | $416.87 | $575.44 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $1,202.26 | Professional | None | $245.47 | $245.47 | $1,202.26 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,621.81 Typical High $4,073.80 | Facility | None | $501.19 | $1,621.81 | $4,073.80 |
United Setting Professional Modifier None Typical Low $107.15 Median $389.05 Typical High $1,230.27 | Professional | None | $107.15 | $389.05 | $1,230.27 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $891.25 | Professional | None | $154.88 | $181.97 | $891.25 |
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 $48.98 Median $66.07 Typical High $295.12 | Professional | 52 · Reduced service | $48.98 | $66.07 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $26.30 Typical High $117.49 | Professional | 53 · Discontinued | $19.50 | $26.30 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $100.00 Typical High $446.68 | Professional | 54 · Surgery only | $79.43 | $100.00 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.95 Typical High $89.13 | Professional | 55 · Aftercare only | $14.79 | $19.95 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.18 Typical High $58.88 | Professional | 56 · Pre-op care only | $9.77 | $13.18 | $58.88 |
Where Iowa sits
The same service costs 7.8 times more in Oklahoma than in Nebraska. 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· 4th of 51
$646
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.