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 $56.23 Median $4,265.80 Typical High $7,244.36 | Facility | None | $56.23 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $177.83 | Professional | None | $45.71 | $79.43 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $69.18 Typical High $85.11 | Facility | None | $54.95 | $69.18 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $208.93 | Professional | None | $107.15 | $144.54 | $208.93 |
Hally Health Setting Professional Modifier None Typical Low $42.66 Median $109.65 Typical High $194.98 | Professional | None | $42.66 | $109.65 | $194.98 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $169.82 Typical High $1,288.25 | Facility | None | $83.18 | $169.82 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $338.84 | Professional | None | $97.72 | $144.54 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $208.93 | Professional | None | $109.65 | $144.54 | $208.93 |
Midlands Setting Facility Modifier None Typical Low $48.98 Median $69.18 Typical High $87.10 | Facility | None | $48.98 | $69.18 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $229.09 | Professional | None | $91.20 | $141.25 | $229.09 |
United Setting Facility Modifier None Typical Low $223.87 Median $630.96 Typical High $1,995.26 | Facility | None | $223.87 | $630.96 | $1,995.26 |
United Setting Professional Modifier None Typical Low $53.70 Median $104.71 Typical High $190.55 | Professional | None | $53.70 | $104.71 | $190.55 |
Wellmark Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $165.96 | Professional | None | $81.28 | $95.50 | $165.96 |
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 $23.44 Median $33.88 Typical High $45.71 | Professional | 52 · Reduced service | $23.44 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.49 Typical High $18.20 | Professional | 53 · Discontinued | $9.33 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $51.29 Typical High $69.18 | Professional | 54 · Surgery only | $35.48 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.23 Typical High $13.80 | Professional | 55 · Aftercare only | $7.08 | $10.23 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.68 | $6.76 | $9.12 |
Where Iowa sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$126
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.