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 $70.79 Median $5,011.87 Typical High $7,943.28 | Facility | None | $70.79 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $138.04 | Professional | None | $53.70 | $83.18 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $85.11 Typical High $109.65 | Facility | None | $70.79 | $85.11 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $251.19 | Professional | None | $128.82 | $177.83 | $251.19 |
Hally Health Setting Professional Modifier None Typical Low $53.70 Median $134.90 Typical High $251.19 | Professional | None | $53.70 | $134.90 | $251.19 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $199.53 Typical High $1,288.25 | Facility | None | $100.00 | $199.53 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $426.58 | Professional | None | $114.82 | $181.97 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $251.19 | Professional | None | $128.82 | $199.53 | $251.19 |
Midlands Setting Facility Modifier None Typical Low $67.61 Median $85.11 Typical High $109.65 | Facility | None | $67.61 | $85.11 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $281.84 | Professional | None | $114.82 | $169.82 | $281.84 |
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 $67.61 Median $128.82 Typical High $234.42 | Professional | None | $67.61 | $128.82 | $234.42 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $218.78 | Professional | None | $100.00 | $117.49 | $218.78 |
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 $28.84 Median $41.69 Typical High $56.23 | Professional | 52 · Reduced service | $28.84 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.60 Typical High $22.39 | Professional | 53 · Discontinued | $11.75 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $63.10 Typical High $85.11 | Professional | 54 · Surgery only | $43.65 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.59 Typical High $16.98 | Professional | 55 · Aftercare only | $8.71 | $12.59 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.32 Typical High $11.22 | Professional | 56 · Pre-op care only | $5.89 | $8.32 | $11.22 |
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
$155
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.