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 $223.87 Median $2,630.27 Typical High $6,760.83 | Facility | None | $223.87 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $223.87 | Professional | None | $112.20 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $165.96 Typical High $199.53 | Facility | None | $128.82 | $165.96 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $380.19 | Professional | None | $257.04 | $295.12 | $380.19 |
Hally Health Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $323.59 | Professional | None | $107.15 | $177.83 | $323.59 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $407.38 Typical High $2,089.30 | Facility | None | $177.83 | $407.38 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $1,174.90 | Professional | None | $173.78 | $346.74 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $363.08 | Professional | None | $223.87 | $309.03 | $363.08 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $158.49 Typical High $199.53 | Facility | None | $114.82 | $158.49 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $549.54 | Professional | None | $288.40 | $316.23 | $549.54 |
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 $125.89 Median $204.17 Typical High $371.54 | Professional | None | $125.89 | $204.17 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $398.11 | Professional | None | $208.93 | $245.47 | $398.11 |
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 $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $54.95 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $44.67 | Professional | 53 · Discontinued | $21.88 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $120.23 Typical High $169.82 | Professional | 54 · Surgery only | $81.28 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $16.22 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $22.39 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$275
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.