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 $275.42 Median $5,888.44 Typical High $7,943.28 | Facility | None | $275.42 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $275.42 | Professional | None | $173.78 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $537.03 | Professional | None | $380.19 | $467.74 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $575.44 | Professional | None | $190.55 | $331.13 | $575.44 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $549.54 Typical High $5,011.87 | Facility | None | $363.08 | $549.54 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $446.68 Typical High $3,090.30 | Professional | None | $223.87 | $446.68 | $3,090.30 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $537.03 | Professional | None | $398.11 | $446.68 | $537.03 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $741.31 | Professional | None | $371.54 | $416.87 | $741.31 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $588.84 | $2,344.23 | $6,918.31 |
United Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $549.54 | Professional | None | $204.17 | $295.12 | $549.54 |
Wellmark Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | None | $380.19 | $380.19 | $446.68 |
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 $87.10 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $87.10 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $34.67 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $131.83 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $26.30 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $27.54 | $27.54 |
Where Iowa sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 6th of 51
$417
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.