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 $218.78 Median $2,630.27 Typical High $6,760.83 | Facility | None | $218.78 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $295.12 | Professional | None | $120.23 | $165.96 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $158.49 Typical High $204.17 | Facility | None | $114.82 | $158.49 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $489.78 | Professional | None | $275.42 | $346.74 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $257.04 Typical High $426.58 | Professional | None | $112.20 | $257.04 | $426.58 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $2,344.23 | Facility | None | $199.53 | $436.52 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $891.25 | Professional | None | $229.09 | $371.54 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $489.78 | Professional | None | $275.42 | $371.54 | $489.78 |
Midlands Setting Facility Modifier None Typical Low $112.20 Median $154.88 Typical High $204.17 | Facility | None | $112.20 | $154.88 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $549.54 | Professional | None | $239.88 | $323.59 | $549.54 |
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 $141.25 Median $257.04 Typical High $446.68 | Professional | None | $141.25 | $257.04 | $446.68 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $426.58 | Professional | None | $218.78 | $257.04 | $426.58 |
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 $61.66 Median $79.43 Typical High $109.65 | Professional | 52 · Reduced service | $61.66 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $24.55 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $120.23 Typical High $162.18 | Professional | 54 · Surgery only | $91.20 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.99 Typical High $33.11 | Professional | 55 · Aftercare only | $18.20 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.30 | $15.85 | $21.88 |
Where Iowa sits
The same service costs 3.7 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
$324
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.