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 $588.84 Median $2,630.27 Typical High $6,760.83 | Facility | None | $588.84 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $588.84 | Professional | None | $309.03 | $457.09 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $288.40 Typical High $389.05 | Facility | None | $120.23 | $288.40 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,096.48 | Professional | None | $660.69 | $851.14 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $288.40 Median $575.44 Typical High $1,096.48 | Professional | None | $288.40 | $575.44 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $812.83 Typical High $1,445.44 | Facility | None | $288.40 | $812.83 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $2,884.03 | Professional | None | $549.54 | $870.96 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,096.48 | Professional | None | $691.83 | $891.25 | $1,096.48 |
Midlands Setting Facility Modifier None Typical Low $120.23 Median $281.84 Typical High $389.05 | Facility | None | $120.23 | $281.84 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,230.27 | Professional | None | $616.60 | $831.76 | $1,230.27 |
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 $346.74 Median $602.56 Typical High $1,000.00 | Professional | None | $346.74 | $602.56 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $954.99 | Professional | None | $549.54 | $645.65 | $954.99 |
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 $154.88 Median $229.09 Typical High $295.12 | Professional | 52 · Reduced service | $154.88 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $91.20 Typical High $117.49 | Professional | 53 · Discontinued | $61.66 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $229.09 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $67.61 Typical High $89.13 | Professional | 55 · Aftercare only | $46.77 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $45.71 Typical High $58.88 | Professional | 56 · Pre-op care only | $30.90 | $45.71 | $58.88 |
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
$741
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.