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 $524.81 Median $3,388.44 Typical High $6,760.83 | Facility | None | $524.81 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $524.81 | Professional | None | $169.82 | $331.13 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $549.54 Typical High $724.44 | Facility | None | $467.74 | $549.54 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $1,047.13 | Professional | None | $371.54 | $524.81 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $501.19 Typical High $870.96 | Professional | None | $151.36 | $501.19 | $870.96 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $891.25 Typical High $2,187.76 | Facility | None | $436.52 | $891.25 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $794.33 Typical High $1,778.28 | Professional | None | $407.38 | $794.33 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $812.83 Typical High $1,047.13 | Professional | None | $371.54 | $812.83 | $1,047.13 |
Midlands Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $724.44 | Facility | None | $446.68 | $549.54 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $1,202.26 | Professional | None | $316.23 | $501.19 | $1,202.26 |
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 $190.55 Median $446.68 Typical High $1,122.02 | Professional | None | $190.55 | $446.68 | $1,122.02 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $851.14 | Professional | None | $295.12 | $346.74 | $851.14 |
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 $85.11 Median $165.96 Typical High $263.03 | Professional | 52 · Reduced service | $85.11 | $165.96 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $67.61 Typical High $104.71 | Professional | 53 · Discontinued | $33.88 | $67.61 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $251.19 Typical High $398.11 | Professional | 54 · Surgery only | $128.82 | $251.19 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $50.12 Typical High $79.43 | Professional | 55 · Aftercare only | $25.70 | $50.12 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $33.11 Typical High $52.48 | Professional | 56 · Pre-op care only | $16.98 | $33.11 | $52.48 |
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· 3rd of 51
$631
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.