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 $67.61 Median $2,630.27 Typical High $6,760.83 | Facility | None | $67.61 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $72.44 Typical High $141.25 | Professional | None | $34.67 | $72.44 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $97.72 Typical High $128.82 | Facility | None | $81.28 | $97.72 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $158.49 Typical High $223.87 | Professional | None | $66.07 | $158.49 | $223.87 |
Hally Health Setting Professional Modifier None Typical Low $27.54 Median $112.20 Typical High $229.09 | Professional | None | $27.54 | $112.20 | $229.09 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $199.53 Typical High $1,318.26 | Facility | None | $77.62 | $199.53 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $165.96 Typical High $323.59 | Professional | None | $81.28 | $165.96 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $66.07 Median $169.82 Typical High $208.93 | Professional | None | $66.07 | $169.82 | $208.93 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $97.72 Typical High $128.82 | Facility | None | $79.43 | $97.72 | $128.82 |
Midlands Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $239.88 | Professional | None | $81.28 | $93.33 | $239.88 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $38.02 Median $91.20 Typical High $208.93 | Professional | None | $38.02 | $91.20 | $208.93 |
Wellmark Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $181.97 | Professional | None | $52.48 | $61.66 | $181.97 |
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 $15.49 Median $34.67 Typical High $54.95 | Professional | 52 · Reduced service | $15.49 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $13.80 Typical High $21.88 | Professional | 53 · Discontinued | $6.17 | $13.80 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $52.48 Typical High $83.18 | Professional | 54 · Surgery only | $22.91 | $52.48 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $10.47 Typical High $16.60 | Professional | 55 · Aftercare only | $4.57 | $10.47 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $6.92 Typical High $10.96 | Professional | 56 · Pre-op care only | $3.09 | $6.92 | $10.96 |
Where Iowa sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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
$129
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.