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 $602.56 Median $3,548.13 Typical High $6,760.83 | Facility | None | $602.56 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $251.19 | Professional | None | $162.18 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,445.44 | Facility | None | $954.99 | $954.99 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $489.78 | Professional | None | $346.74 | $354.81 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $467.74 | Professional | None | $165.96 | $281.84 | $467.74 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $446.68 Typical High $1,905.46 | Facility | None | $269.15 | $446.68 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $1,318.26 | Professional | None | $208.93 | $346.74 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $446.68 | Professional | None | $302.00 | $354.81 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,548.82 | Facility | None | $954.99 | $1,348.96 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $660.69 | Professional | None | $295.12 | $371.54 | $660.69 |
United Setting Facility Modifier None Typical Low $158.49 Median $954.99 Typical High $1,995.26 | Facility | None | $158.49 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $512.86 | Professional | None | $181.97 | $275.42 | $512.86 |
Wellmark Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | None | $309.03 | $309.03 | $363.08 |
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 $81.28 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $81.28 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $32.36 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $123.03 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $24.55 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.22 | $25.12 | $25.12 |
Where Iowa sits
The same service costs 4.5 times more in Alaska than in New York. 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
$347
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.