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 $194.98 Median $5,011.87 Typical High $7,943.28 | Facility | None | $194.98 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $234.42 | Professional | None | $123.03 | $194.98 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $117.49 Typical High $141.25 | Facility | None | $100.00 | $117.49 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $436.52 | Professional | None | $288.40 | $354.81 | $436.52 |
Hally Health Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $436.52 | Professional | None | $120.23 | $234.42 | $436.52 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $380.19 Typical High $2,344.23 | Facility | None | $138.04 | $380.19 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $933.25 | Professional | None | $218.78 | $346.74 | $933.25 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $436.52 | Professional | None | $295.12 | $354.81 | $436.52 |
Midlands Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $141.25 | Facility | None | $91.20 | $117.49 | $141.25 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $478.63 | Professional | None | $263.03 | $354.81 | $478.63 |
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 $147.91 Median $234.42 Typical High $407.38 | Professional | None | $147.91 | $234.42 | $407.38 |
Wellmark Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $380.19 | Professional | None | $234.42 | $275.42 | $380.19 |
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 $66.07 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $66.07 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $26.30 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $144.54 Typical High $177.83 | Professional | 54 · Surgery only | $100.00 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $13.18 | $19.50 | $23.44 |
Where Iowa sits
The same service costs 2.9 times more in Alaska 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· 4th 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.