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 $234.42 Median $2,630.27 Typical High $6,760.83 | Facility | None | $234.42 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $234.42 | Professional | None | $74.13 | $147.91 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $194.98 Typical High $245.47 | Facility | None | $109.65 | $194.98 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $446.68 | Professional | None | $141.25 | $223.87 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $66.07 Median $213.80 Typical High $302.00 | Professional | None | $66.07 | $213.80 | $302.00 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $302.00 Typical High $1,621.81 | Facility | None | $158.49 | $302.00 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $776.25 | Professional | None | $151.36 | $275.42 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $446.68 | Professional | None | $141.25 | $288.40 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $245.47 | Facility | None | $109.65 | $190.55 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $512.86 | Professional | None | $134.90 | $208.93 | $512.86 |
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 $83.18 Median $173.78 Typical High $371.54 | Professional | None | $83.18 | $173.78 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $389.05 | Professional | None | $128.82 | $151.36 | $389.05 |
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 $37.15 Median $63.10 Typical High $117.49 | Professional | 52 · Reduced service | $37.15 | $63.10 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $25.12 Typical High $46.77 | Professional | 53 · Discontinued | $14.79 | $25.12 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $95.50 Typical High $173.78 | Professional | 54 · Surgery only | $54.95 | $95.50 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $19.05 Typical High $34.67 | Professional | 55 · Aftercare only | $11.22 | $19.05 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.59 Typical High $23.44 | Professional | 56 · Pre-op care only | $7.41 | $12.59 | $23.44 |
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· 5th of 51
$229
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.