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 $6,456.54 Typical High $7,943.28 | Facility | None | $4,265.80 | $6,456.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $6,456.54 Typical High $6,456.54 | Professional | None | $1,995.26 | $6,456.54 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $4,570.88 Typical High $5,248.07 | Professional | None | $645.65 | $4,570.88 | $5,248.07 |
Hally Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,884.03 Typical High $10,715.19 | Professional | None | $1,698.24 | $2,884.03 | $10,715.19 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $2,884.03 Typical High $5,888.44 | Facility | None | $489.78 | $2,884.03 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $3,388.44 Median $4,786.30 Typical High $7,762.47 | Professional | None | $3,388.44 | $4,786.30 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $3,467.37 Median $4,897.79 Typical High $4,897.79 | Professional | None | $3,467.37 | $4,897.79 | $4,897.79 |
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 $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Wellmark Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,365.16 | Professional | None | $3,890.45 | $3,890.45 | $4,365.16 |
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 $1,000.00 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $1,000.00 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $398.11 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $1,479.11 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $295.12 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $199.53 | $645.65 | $645.65 |
Where Iowa sits
The same service costs 218.8 times more in Alabama 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· 4th of 51
$4,365
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.