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 $407.38 Median $5,888.44 Typical High $7,943.28 | Facility | None | $407.38 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $407.38 | Professional | None | $229.09 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $691.83 | Professional | None | $316.23 | $512.86 | $691.83 |
Hally Health Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $3,311.31 | Professional | None | $257.04 | $407.38 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $1,096.48 Typical High $5,128.61 | Facility | None | $363.08 | $1,096.48 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $4,365.16 | Professional | None | $269.15 | $501.19 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $4,897.79 | Professional | None | $436.52 | $512.86 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $4,897.79 | Professional | None | $478.63 | $616.60 | $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 $245.47 Median $338.84 Typical High $630.96 | Professional | None | $245.47 | $338.84 | $630.96 |
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 |
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 $173.78 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $173.78 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $34.67 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.91 | $40.74 | $40.74 |
Where Iowa sits
The same service costs 8.1 times more in New York than in Missouri. 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
$513
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.