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 $316.23 Median $2,630.27 Typical High $6,760.83 | Facility | None | $316.23 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $316.23 | Professional | None | $213.80 | $263.03 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $389.05 | Facility | None | $204.17 | $288.40 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $707.95 | Professional | None | $478.63 | $575.44 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $645.65 | Professional | None | $194.98 | $371.54 | $645.65 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $602.56 Typical High $1,621.81 | Facility | None | $309.03 | $602.56 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $3,090.30 | Professional | None | $354.81 | $562.34 | $3,090.30 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $707.95 | Professional | None | $478.63 | $575.44 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $208.93 Median $288.40 Typical High $389.05 | Facility | None | $208.93 | $288.40 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $794.33 | Professional | None | $398.11 | $575.44 | $794.33 |
United Setting Facility Modifier None Typical Low $223.87 Median $812.83 Typical High $1,995.26 | Facility | None | $223.87 | $812.83 | $1,995.26 |
United Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $691.83 | Professional | None | $245.47 | $389.05 | $691.83 |
Wellmark Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $602.56 | Professional | None | $371.54 | $436.52 | $602.56 |
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 $104.71 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $104.71 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $42.66 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $158.49 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.38 | $26.30 | $31.62 |
Where Iowa sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 4th of 51
$513
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.