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 $776.25 Median $2,951.21 Typical High $6,760.83 | Facility | None | $776.25 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $776.25 | Professional | None | $501.19 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $2,754.23 | Facility | None | $645.65 | $2,290.87 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,148.15 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $912.01 Typical High $4,073.80 | Professional | None | $524.81 | $912.01 | $4,073.80 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $2,290.87 Typical High $5,888.44 | Facility | None | $776.25 | $2,290.87 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,122.02 Typical High $14,125.38 | Professional | None | $660.69 | $1,122.02 | $14,125.38 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,584.89 | Professional | None | $977.24 | $1,148.15 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $2,754.23 | Facility | None | $1,258.93 | $2,290.87 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $9,120.11 | Professional | None | $851.14 | $1,230.27 | $9,120.11 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,019.95 Typical High $6,025.60 | Facility | None | $724.44 | $3,019.95 | $6,025.60 |
United Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,737.80 | Professional | None | $549.54 | $831.76 | $1,737.80 |
Wellmark Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,096.48 | $1,288.25 |
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 $251.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $251.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $100.00 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $371.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $74.13 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $50.12 | $77.62 | $77.62 |
Where Iowa sits
The same service costs 4.5 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· 7th of 51
$1,148
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.