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 $125.89 Median $2,630.27 Typical High $6,760.83 | Facility | None | $125.89 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $138.04 | Professional | None | $51.29 | $95.50 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $239.88 | Professional | None | $91.20 | $134.90 | $239.88 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $131.83 Typical High $323.59 | Professional | None | $40.74 | $131.83 | $323.59 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $234.42 Typical High $1,778.28 | Facility | None | $114.82 | $234.42 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $194.98 Typical High $1,778.28 | Professional | None | $95.50 | $194.98 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $223.87 | Professional | None | $97.72 | $169.82 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $239.88 | Professional | None | $114.82 | $181.97 | $239.88 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $2,398.83 | Facility | None | $1,047.13 | $1,737.80 | $2,398.83 |
United Setting Professional Modifier None Typical Low $51.29 Median $109.65 Typical High $223.87 | Professional | None | $51.29 | $109.65 | $223.87 |
Wellmark Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $213.80 | Professional | None | $75.86 | $93.33 | $213.80 |
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 $22.39 Median $39.81 Typical High $64.57 | Professional | 52 · Reduced service | $22.39 | $39.81 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $15.85 Typical High $25.70 | Professional | 53 · Discontinued | $9.12 | $15.85 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $58.88 Typical High $97.72 | Professional | 54 · Surgery only | $33.88 | $58.88 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $11.75 Typical High $19.50 | Professional | 55 · Aftercare only | $6.76 | $11.75 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.94 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.47 | $7.94 | $12.88 |
Where Iowa sits
The same service costs 2.5 times more in North Carolina 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· 4th of 51
$138
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.