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 $263.03 Median $2,630.27 Typical High $6,760.83 | Facility | None | $263.03 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $138.04 Typical High $263.03 | Professional | None | $40.74 | $138.04 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $131.83 | Facility | None | $104.71 | $114.82 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $389.05 | Professional | None | $91.20 | $144.54 | $389.05 |
Hally Health Setting Professional Modifier None Typical Low $37.15 Median $151.36 Typical High $269.15 | Professional | None | $37.15 | $151.36 | $269.15 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $436.52 Typical High $2,754.23 | Facility | None | $102.33 | $436.52 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $346.74 Typical High $1,202.26 | Professional | None | $89.13 | $346.74 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $302.00 Typical High $407.38 | Professional | None | $91.20 | $302.00 | $407.38 |
Midlands Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $131.83 | Facility | None | $104.71 | $114.82 | $131.83 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $302.00 Typical High $457.09 | Professional | None | $102.33 | $302.00 | $457.09 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $4,073.80 | Facility | None | $501.19 | $1,819.70 | $4,073.80 |
United Setting Professional Modifier None Typical Low $45.71 Median $125.89 Typical High $363.08 | Professional | None | $45.71 | $125.89 | $363.08 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $416.87 | Professional | None | $83.18 | $95.50 | $416.87 |
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 $20.42 Median $57.54 Typical High $131.83 | Professional | 52 · Reduced service | $20.42 | $57.54 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $23.44 Typical High $52.48 | Professional | 53 · Discontinued | $8.13 | $23.44 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $87.10 Typical High $194.98 | Professional | 54 · Surgery only | $30.20 | $87.10 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $17.38 Typical High $38.90 | Professional | 55 · Aftercare only | $6.17 | $17.38 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $11.75 Typical High $26.30 | Professional | 56 · Pre-op care only | $4.07 | $11.75 | $26.30 |
Where Iowa sits
The same service costs 4.6 times more in Wisconsin than in Washington, DC. 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
$204
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.