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 $4,265.80 Median $6,025.60 Typical High $7,943.28 | Facility | None | $4,265.80 | $6,025.60 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $6,025.60 Typical High $6,025.60 | Professional | None | $1,659.59 | $6,025.60 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $4,897.79 Typical High $5,128.61 | Professional | None | $630.96 | $4,897.79 | $5,128.61 |
Hally Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,570.40 Typical High $6,309.57 | Professional | None | $1,778.28 | $2,570.40 | $6,309.57 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $2,818.38 Typical High $5,888.44 | Facility | None | $489.78 | $2,818.38 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $3,548.13 Median $5,011.87 Typical High $5,011.87 | Professional | None | $3,548.13 | $5,011.87 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Midlands Setting Professional Modifier None Typical Low $3,630.78 Median $5,128.61 Typical High $5,128.61 | Professional | None | $3,630.78 | $5,128.61 | $5,128.61 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $588.84 | $2,344.23 | $6,918.31 |
Wellmark Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,570.88 | Professional | None | $4,168.69 | $4,168.69 | $4,570.88 |
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 $831.76 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $831.76 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $331.13 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,230.27 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $245.47 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $165.96 | $602.56 | $602.56 |
Where Iowa sits
The same service costs 204.2 times more in Wisconsin than in Hawaii. 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· 7th of 51
$4,571
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.