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 $173.78 Median $2,630.27 Typical High $6,760.83 | Facility | None | $173.78 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $194.98 | Professional | None | $70.79 | $117.49 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $323.59 | Professional | None | $104.71 | $186.21 | $323.59 |
Hally Health Setting Professional Modifier None Typical Low $64.57 Median $154.88 Typical High $281.84 | Professional | None | $64.57 | $154.88 | $281.84 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $263.03 Typical High $1,621.81 | Facility | None | $173.78 | $263.03 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $269.15 Typical High $3,548.13 | Professional | None | $131.83 | $269.15 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $302.00 | Professional | None | $134.90 | $204.17 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $323.59 | Professional | None | $134.90 | $181.97 | $323.59 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,630.78 | Facility | None | $1,096.48 | $1,737.80 | $3,630.78 |
United Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $295.12 | Professional | None | $81.28 | $151.36 | $295.12 |
Wellmark Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $275.42 | Professional | None | $123.03 | $151.36 | $275.42 |
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 $35.48 Median $56.23 Typical High $85.11 | Professional | 52 · Reduced service | $35.48 | $56.23 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $22.39 Typical High $34.67 | Professional | 53 · Discontinued | $14.13 | $22.39 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $85.11 Typical High $128.82 | Professional | 54 · Surgery only | $52.48 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $16.98 Typical High $25.70 | Professional | 55 · Aftercare only | $10.72 | $16.98 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.22 Typical High $17.38 | Professional | 56 · Pre-op care only | $7.08 | $11.22 | $17.38 |
Where Iowa sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$186
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.