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 $141.25 Median $2,630.27 Typical High $6,760.83 | Facility | None | $141.25 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $102.33 Typical High $169.82 | Professional | None | $58.88 | $102.33 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $112.20 Typical High $144.54 | Facility | None | $93.33 | $112.20 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $269.15 | Professional | None | $120.23 | $165.96 | $269.15 |
Hally Health Setting Professional Modifier None Typical Low $47.86 Median $144.54 Typical High $295.12 | Professional | None | $47.86 | $144.54 | $295.12 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $239.88 Typical High $1,288.25 | Facility | None | $120.23 | $239.88 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $588.84 | Professional | None | $117.49 | $208.93 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $269.15 | Professional | None | $120.23 | $213.80 | $269.15 |
Midlands Setting Facility Modifier None Typical Low $91.20 Median $112.20 Typical High $144.54 | Facility | None | $91.20 | $112.20 | $144.54 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $302.00 | Professional | None | $100.00 | $154.88 | $302.00 |
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 $64.57 Median $128.82 Typical High $269.15 | Professional | None | $64.57 | $128.82 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $239.88 | Professional | None | $93.33 | $109.65 | $239.88 |
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 $26.92 Median $45.71 Typical High $70.79 | Professional | 52 · Reduced service | $26.92 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $18.20 Typical High $28.18 | Professional | 53 · Discontinued | $10.72 | $18.20 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $67.61 Typical High $107.15 | Professional | 54 · Surgery only | $40.74 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $13.49 Typical High $21.38 | Professional | 55 · Aftercare only | $8.13 | $13.49 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $9.12 Typical High $14.13 | Professional | 56 · Pre-op care only | $5.37 | $9.12 | $14.13 |
Where Iowa sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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
$170
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.