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 $302.00 Median $2,630.27 Typical High $6,760.83 | Facility | None | $302.00 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $302.00 | Professional | None | $162.18 | $234.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $190.55 | Facility | None | $125.89 | $151.36 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $478.63 | Professional | None | $316.23 | $407.38 | $478.63 |
Hally Health Setting Professional Modifier None Typical Low $131.83 Median $245.47 Typical High $407.38 | Professional | None | $131.83 | $245.47 | $407.38 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $446.68 Typical High $2,344.23 | Facility | None | $169.82 | $446.68 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $1,047.13 | Professional | None | $251.19 | $389.05 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $478.63 | Professional | None | $316.23 | $407.38 | $478.63 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $190.55 | Facility | None | $114.82 | $151.36 | $190.55 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $537.03 | Professional | None | $269.15 | $371.54 | $537.03 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $4,073.80 | Facility | None | $501.19 | $1,819.70 | $4,073.80 |
United Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $489.78 | Professional | None | $165.96 | $269.15 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $436.52 | Professional | None | $257.04 | $302.00 | $436.52 |
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 $79.43 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $79.43 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $46.77 Typical High $60.26 | Professional | 53 · Discontinued | $32.36 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $177.83 Typical High $223.87 | Professional | 54 · Surgery only | $120.23 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $35.48 Typical High $44.67 | Professional | 55 · Aftercare only | $23.99 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.44 Typical High $30.20 | Professional | 56 · Pre-op care only | $16.22 | $23.44 | $30.20 |
Where Iowa sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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
$372
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.