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 $575.44 Median $5,888.44 Typical High $7,943.28 | Facility | None | $575.44 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $575.44 | Professional | None | $323.59 | $575.44 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,513.56 | Professional | None | $741.31 | $812.83 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $4,168.69 | Professional | None | $354.81 | $724.44 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,174.90 Typical High $6,456.54 | Facility | None | $562.34 | $1,174.90 | $6,456.54 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $851.14 Typical High $16,218.10 | Professional | None | $489.78 | $851.14 | $16,218.10 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $6,165.95 | Professional | None | $812.83 | $812.83 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $6,165.95 | Professional | None | $776.25 | $933.25 | $6,165.95 |
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 $407.38 Median $645.65 Typical High $1,122.02 | Professional | None | $407.38 | $645.65 | $1,122.02 |
Wellmark Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,495.41 | Professional | None | $5,011.87 | $5,011.87 | $5,495.41 |
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 $239.88 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $239.88 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $48.98 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $32.36 | $57.54 | $57.54 |
Where Iowa sits
The same service costs 15.1 times more in New York 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· 8th of 51
$912
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.