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 $1,819.70 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,819.70 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $3,630.78 | Professional | None | $1,202.26 | $2,454.71 | $3,630.78 |
Hally Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $5,011.87 | Professional | None | $1,380.38 | $1,949.84 | $5,011.87 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $2,398.83 Typical High $5,888.44 | Facility | None | $562.34 | $2,398.83 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $8,511.38 | Professional | None | $1,202.26 | $2,398.83 | $8,511.38 |
Midlands Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,168.69 | Professional | None | $2,454.71 | $2,454.71 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $4,168.69 | Professional | None | $2,511.89 | $3,467.37 | $4,168.69 |
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 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,071.52 | $1,584.89 | $2,951.21 |
Wellmark Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,715.35 | Professional | None | $3,311.31 | $3,311.31 | $3,715.35 |
3 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 54 · Surgery only Typical Low $758.58 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $758.58 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $154.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $102.33 | $181.97 | $181.97 |
Where Iowa sits
The same service costs 5.6 times more in Alaska than in New York. 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
$2,455
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.