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 $954.99 Median $3,548.13 Typical High $6,760.83 | Facility | None | $954.99 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $954.99 | Professional | None | $616.60 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $2,754.23 | Facility | None | $954.99 | $954.99 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,479.11 | $1,862.09 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $1,819.70 | Professional | None | $630.96 | $1,096.48 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $1,318.26 Typical High $1,905.46 | Facility | None | $416.87 | $1,318.26 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,479.11 Typical High $5,011.87 | Professional | None | $794.33 | $1,479.11 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,479.11 | $1,862.09 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $2,570.40 Typical High $2,951.21 | Facility | None | $954.99 | $2,570.40 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,412.54 | $2,570.40 |
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 $691.83 Median $1,047.13 Typical High $1,949.84 | Professional | None | $691.83 | $1,047.13 | $1,949.84 |
Wellmark Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,174.90 | $1,380.38 |
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 $309.03 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $309.03 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $123.03 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $467.74 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $93.33 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $61.66 | $95.50 | $95.50 |
Where Iowa sits
The same service costs 4.7 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· 7th of 51
$1,318
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.