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 $125.89 Median $2,630.27 Typical High $6,760.83 | Facility | None | $125.89 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $158.49 | Professional | None | $61.66 | $95.50 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $97.72 Typical High $125.89 | Facility | None | $69.18 | $97.72 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $288.40 | Professional | None | $151.36 | $194.98 | $288.40 |
Hally Health Setting Professional Modifier None Typical Low $60.26 Median $147.91 Typical High $251.19 | Professional | None | $60.26 | $147.91 | $251.19 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $245.47 Typical High $2,344.23 | Facility | None | $120.23 | $245.47 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $758.58 | Professional | None | $123.03 | $204.17 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $288.40 | Professional | None | $154.88 | $208.93 | $288.40 |
Midlands Setting Facility Modifier None Typical Low $67.61 Median $95.50 Typical High $125.89 | Facility | None | $67.61 | $95.50 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $323.59 | Professional | None | $128.82 | $173.78 | $323.59 |
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 $75.86 Median $141.25 Typical High $251.19 | Professional | None | $75.86 | $141.25 | $251.19 |
Wellmark Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $245.47 | Professional | None | $117.49 | $138.04 | $245.47 |
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 $32.36 Median $44.67 Typical High $63.10 | Professional | 52 · Reduced service | $32.36 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $18.20 Typical High $25.12 | Professional | 53 · Discontinued | $12.88 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $67.61 Typical High $95.50 | Professional | 54 · Surgery only | $48.98 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.49 Typical High $19.05 | Professional | 55 · Aftercare only | $9.77 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.12 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.46 | $9.12 | $12.59 |
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
$174
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.