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 $602.56 Median $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $1,479.11 Typical High $3,090.30 | Professional | None | $389.05 | $1,479.11 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,584.89 | $2,818.38 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $5,888.44 | Professional | None | $616.60 | $1,202.26 | $5,888.44 |
Hally Health Setting Professional Modifier None Typical Low $407.38 Median $2,089.30 Typical High $6,760.83 | Professional | None | $407.38 | $2,089.30 | $6,760.83 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $3,162.28 Typical High $7,413.10 | Facility | None | $954.99 | $3,162.28 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $4,073.80 Typical High $6,760.83 | Professional | None | $1,000.00 | $4,073.80 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $4,168.69 Typical High $5,888.44 | Professional | None | $616.60 | $4,168.69 | $5,888.44 |
Midlands Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $3,630.78 | Facility | None | $1,584.89 | $2,754.23 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $5,370.32 | Professional | None | $1,000.00 | $1,174.90 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $9,332.54 | Facility | None | $1,258.93 | $3,630.78 | $9,332.54 |
United Setting Professional Modifier None Typical Low $436.52 Median $1,584.89 Typical High $4,897.79 | Professional | None | $436.52 | $1,584.89 | $4,897.79 |
Wellmark Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $7,943.28 | Professional | None | $707.95 | $831.76 | $7,943.28 |
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 $199.53 Median $426.58 Typical High $1,148.15 | Professional | 52 · Reduced service | $199.53 | $426.58 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $169.82 Typical High $467.74 | Professional | 53 · Discontinued | $79.43 | $169.82 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $645.65 Typical High $1,737.80 | Professional | 54 · Surgery only | $302.00 | $645.65 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $128.82 Typical High $346.74 | Professional | 55 · Aftercare only | $60.26 | $128.82 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $85.11 Typical High $234.42 | Professional | 56 · Pre-op care only | $39.81 | $85.11 | $234.42 |
Where Iowa sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 1st of 51
$2,692
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.