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 $371.54 Median $3,388.44 Typical High $6,760.83 | Facility | None | $371.54 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $371.54 | Professional | None | $134.90 | $223.87 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $1,071.52 Typical High $1,258.93 | Facility | None | $173.78 | $1,071.52 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $645.65 | Professional | None | $234.42 | $363.08 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $102.33 Median $263.03 Typical High $398.11 | Professional | None | $102.33 | $263.03 | $398.11 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $630.96 Typical High $3,890.45 | Facility | None | $275.42 | $630.96 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $416.87 Typical High $912.01 | Professional | None | $239.88 | $416.87 | $912.01 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $512.86 Typical High $645.65 | Professional | None | $245.47 | $512.86 | $645.65 |
Midlands Setting Facility Modifier None Typical Low $177.83 Median $1,047.13 Typical High $1,258.93 | Facility | None | $177.83 | $1,047.13 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $724.44 | Professional | None | $213.80 | $338.84 | $724.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $4,897.79 | Facility | None | $501.19 | $1,949.84 | $4,897.79 |
United Setting Professional Modifier None Typical Low $125.89 Median $275.42 Typical High $575.44 | Professional | None | $125.89 | $275.42 | $575.44 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $630.96 | Professional | None | $204.17 | $239.88 | $630.96 |
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 $66.07 Median $87.10 Typical High $186.21 | Professional | 52 · Reduced service | $66.07 | $87.10 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $34.67 Typical High $74.13 | Professional | 53 · Discontinued | $26.92 | $34.67 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $128.82 Typical High $275.42 | Professional | 54 · Surgery only | $100.00 | $128.82 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.70 Typical High $54.95 | Professional | 55 · Aftercare only | $19.95 | $25.70 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.38 Typical High $37.15 | Professional | 56 · Pre-op care only | $13.49 | $17.38 | $37.15 |
Where Iowa sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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
$407
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.