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 $46.77 Median $2,630.27 Typical High $6,760.83 | Facility | None | $46.77 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $69.18 | Professional | None | $28.18 | $38.02 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $30.90 | Facility | None | $28.84 | $28.84 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $100.00 | Professional | None | $64.57 | $85.11 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $26.92 Median $56.23 Typical High $144.54 | Professional | None | $26.92 | $56.23 | $144.54 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $95.50 Typical High $1,380.38 | Facility | None | $69.18 | $95.50 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $457.09 | Professional | None | $54.95 | $89.13 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $100.00 | Professional | None | $64.57 | $85.11 | $100.00 |
Midlands Setting Facility Modifier None Typical Low $28.84 Median $30.90 Typical High $33.11 | Facility | None | $28.84 | $30.90 | $33.11 |
Midlands Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $120.23 | Professional | None | $56.23 | $77.62 | $120.23 |
United Setting Facility Modifier None Typical Low $158.49 Median $954.99 Typical High $1,995.26 | Facility | None | $158.49 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $33.88 Median $58.88 Typical High $102.33 | Professional | None | $33.88 | $58.88 | $102.33 |
Wellmark Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $91.20 | Professional | None | $51.29 | $60.26 | $91.20 |
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 $14.45 Median $17.78 Typical High $23.44 | Professional | 52 · Reduced service | $14.45 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $7.08 Typical High $9.33 | Professional | 53 · Discontinued | $5.89 | $7.08 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $26.92 Typical High $34.67 | Professional | 54 · Surgery only | $21.88 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.37 Typical High $6.92 | Professional | 55 · Aftercare only | $4.37 | $5.37 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.55 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.88 | $3.55 | $4.68 |
Where Iowa sits
The same service costs 3.3 times more in Alaska 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· 4th of 51
$77.62
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.