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 $199.53 Median $2,630.27 Typical High $6,760.83 | Facility | None | $199.53 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $199.53 | Professional | None | $91.20 | $138.04 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $549.54 Typical High $645.65 | Facility | None | $436.52 | $549.54 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $371.54 | Professional | None | $177.83 | $251.19 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $74.13 Median $190.55 Typical High $407.38 | Professional | None | $74.13 | $190.55 | $407.38 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $478.63 Typical High $2,187.76 | Facility | None | $213.80 | $478.63 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $1,819.70 | Professional | None | $169.82 | $295.12 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $371.54 | Professional | None | $177.83 | $295.12 | $371.54 |
Midlands Setting Facility Modifier None Typical Low $436.52 Median $549.54 Typical High $645.65 | Facility | None | $436.52 | $549.54 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $426.58 | Professional | None | $151.36 | $208.93 | $426.58 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $4,073.80 | Facility | None | $501.19 | $1,659.59 | $4,073.80 |
United Setting Professional Modifier None Typical Low $95.50 Median $190.55 Typical High $371.54 | Professional | None | $95.50 | $190.55 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $331.13 | Professional | None | $144.54 | $173.78 | $331.13 |
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 $41.69 Median $63.10 Typical High $100.00 | Professional | 52 · Reduced service | $41.69 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $25.12 Typical High $39.81 | Professional | 53 · Discontinued | $16.60 | $25.12 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $93.33 Typical High $147.91 | Professional | 54 · Surgery only | $61.66 | $93.33 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.05 Typical High $29.51 | Professional | 55 · Aftercare only | $12.59 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.59 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.32 | $12.59 | $19.95 |
Where Iowa sits
The same service costs 3.6 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· 3rd of 51
$269
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.