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 $102.33 Median $263.03 Typical High $6,309.57 | Facility | None | $102.33 | $263.03 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $104.71 Typical High $223.87 | Professional | None | $51.29 | $104.71 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $302.00 | Professional | None | $100.00 | $158.49 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $46.77 Median $138.04 Typical High $234.42 | Professional | None | $46.77 | $138.04 | $234.42 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $194.98 Typical High $1,348.96 | Facility | None | $112.20 | $194.98 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $177.83 Typical High $457.09 | Professional | None | $97.72 | $177.83 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $302.00 | Professional | None | $100.00 | $181.97 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $346.74 | Professional | None | $97.72 | $134.90 | $346.74 |
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 $60.26 Median $123.03 Typical High $239.88 | Professional | None | $60.26 | $123.03 | $239.88 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $245.47 | Professional | None | $87.10 | $102.33 | $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 $25.70 Median $37.15 Typical High $67.61 | Professional | 52 · Reduced service | $25.70 | $37.15 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $15.14 Typical High $26.92 | Professional | 53 · Discontinued | $10.23 | $15.14 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $56.23 Typical High $100.00 | Professional | 54 · Surgery only | $38.90 | $56.23 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $11.22 Typical High $19.95 | Professional | 55 · Aftercare only | $7.76 | $11.22 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.41 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.13 | $7.41 | $13.49 |
Where Iowa sits
The same service costs 3.2 times more in Alaska than in New York. 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
$145
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.