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 $251.19 Median $2,630.27 Typical High $6,760.83 | Facility | None | $251.19 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $323.59 | Professional | None | $109.65 | $165.96 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $208.93 Typical High $251.19 | Facility | None | $141.25 | $208.93 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $416.87 | Professional | None | $263.03 | $316.23 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $331.13 | Professional | None | $107.15 | $186.21 | $331.13 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $436.52 Typical High $2,089.30 | Facility | None | $190.55 | $436.52 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $371.54 Typical High $1,318.26 | Professional | None | $190.55 | $371.54 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $380.19 | Professional | None | $234.42 | $323.59 | $380.19 |
Midlands Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $251.19 | Facility | None | $141.25 | $194.98 | $251.19 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $575.44 | Professional | None | $316.23 | $316.23 | $575.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $4,073.80 | Facility | None | $501.19 | $1,659.59 | $4,073.80 |
United Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $398.11 | Professional | None | $131.83 | $218.78 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $446.68 | Professional | None | $208.93 | $245.47 | $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 $54.95 Median $81.28 Typical High $125.89 | Professional | 52 · Reduced service | $54.95 | $81.28 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $50.12 | Professional | 53 · Discontinued | $21.88 | $32.36 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $123.03 Typical High $186.21 | Professional | 54 · Surgery only | $83.18 | $123.03 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $25.12 |
Where Iowa sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 5th of 51
$288
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.