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 $251.19 Median $2,630.27 Typical High $6,760.83 | Facility | None | $251.19 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $138.04 Typical High $251.19 | Professional | None | $61.66 | $138.04 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $426.58 | Professional | None | $114.82 | $186.21 | $426.58 |
Hally Health Setting Professional Modifier None Typical Low $57.54 Median $208.93 Typical High $302.00 | Professional | None | $57.54 | $208.93 | $302.00 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $281.84 Typical High $1,621.81 | Facility | None | $162.18 | $281.84 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $380.19 Typical High $2,951.21 | Professional | None | $151.36 | $380.19 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $389.05 | Professional | None | $144.54 | $275.42 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $257.04 Typical High $426.58 | Professional | None | $117.49 | $257.04 | $426.58 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,630.78 | Facility | None | $1,096.48 | $1,737.80 | $3,630.78 |
United Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $416.87 | Professional | None | $74.13 | $173.78 | $416.87 |
Wellmark Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $363.08 | Professional | None | $114.82 | $131.83 | $363.08 |
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 $30.90 Median $67.61 Typical High $125.89 | Professional | 52 · Reduced service | $30.90 | $67.61 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $26.92 Typical High $50.12 | Professional | 53 · Discontinued | $12.30 | $26.92 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $102.33 Typical High $186.21 | Professional | 54 · Surgery only | $45.71 | $102.33 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $20.42 Typical High $38.02 | Professional | 55 · Aftercare only | $9.12 | $20.42 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $13.49 Typical High $25.12 | Professional | 56 · Pre-op care only | $6.17 | $13.49 | $25.12 |
Where Iowa sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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
$245
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.