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 $6,760.83 Typical High $7,943.28 | Facility | None | $4,265.80 | $6,760.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $7,585.78 Typical High $7,585.78 | Professional | None | $3,162.28 | $7,585.78 | $7,585.78 |
Hally Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,981.07 Typical High $5,128.61 | Professional | None | $3,090.30 | $3,981.07 | $5,128.61 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $2,884.03 Typical High $8,912.51 | Facility | None | $489.78 | $2,884.03 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $6,309.57 Median $8,912.51 Typical High $42,657.95 | Professional | None | $6,309.57 | $8,912.51 | $42,657.95 |
Midlands Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
Midlands Setting Professional Modifier None Typical Low $6,606.93 Median $9,120.11 Typical High $9,120.11 | Professional | None | $6,606.93 | $9,120.11 | $9,120.11 |
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 $7,413.10 Median $7,413.10 Typical High $8,128.31 | Professional | None | $7,413.10 | $7,413.10 | $8,128.31 |
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 $1,584.89 Median $3,801.89 Typical High $3,801.89 | Professional | 52 · Reduced service | $1,584.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $1,513.56 Typical High $1,513.56 | Professional | 53 · Discontinued | $630.96 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $5,623.41 Typical High $5,623.41 | Professional | 54 · Surgery only | $2,344.23 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $1,122.02 Typical High $1,122.02 | Professional | 55 · Aftercare only | $467.74 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $758.58 Typical High $758.58 | Professional | 56 · Pre-op care only | $316.23 | $758.58 | $758.58 |
Where Iowa sits
The same service costs 257.0 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
$7,413
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.