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 $141.25 Median $5,011.87 Typical High $7,943.28 | Facility | None | $141.25 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $213.80 | Professional | None | $87.10 | $141.25 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $123.03 Typical High $154.88 | Facility | None | $102.33 | $123.03 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $354.81 | Professional | None | $190.55 | $269.15 | $354.81 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $169.82 Typical High $331.13 | Professional | None | $77.62 | $169.82 | $331.13 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $323.59 Typical High $2,137.96 | Facility | None | $147.91 | $323.59 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $630.96 | Professional | None | $165.96 | $257.04 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $331.13 | Professional | None | $190.55 | $269.15 | $331.13 |
Midlands Setting Facility Modifier None Typical Low $93.33 Median $123.03 Typical High $154.88 | Facility | None | $93.33 | $123.03 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $371.54 | Professional | None | $162.18 | $223.87 | $371.54 |
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 $97.72 Median $181.97 Typical High $323.59 | Professional | None | $97.72 | $181.97 | $323.59 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $295.12 | Professional | None | $154.88 | $181.97 | $295.12 |
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 $47.86 Median $70.79 Typical High $100.00 | Professional | 52 · Reduced service | $47.86 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $28.18 Typical High $39.81 | Professional | 53 · Discontinued | $19.50 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $104.71 Typical High $147.91 | Professional | 54 · Surgery only | $72.44 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.89 Typical High $29.51 | Professional | 55 · Aftercare only | $14.45 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $14.13 Typical High $19.95 | Professional | 56 · Pre-op care only | $9.55 | $14.13 | $19.95 |
Where Iowa sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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
$224
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.