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 $177.83 Median $5,011.87 Typical High $7,943.28 | Facility | None | $177.83 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $204.17 | Professional | None | $102.33 | $177.83 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $79.43 | Facility | None | $74.13 | $74.13 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $257.04 Typical High $309.03 | Professional | None | $120.23 | $257.04 | $309.03 |
Hally Health Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $213.80 | Professional | None | $91.20 | $151.36 | $213.80 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $1,318.26 | Facility | None | $181.97 | $302.00 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $2,187.76 | Professional | None | $158.49 | $275.42 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $295.12 | Professional | None | $223.87 | $257.04 | $295.12 |
Midlands Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $87.10 | Facility | None | $74.13 | $79.43 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
United Setting Facility Modifier None Typical Low $223.87 Median $977.24 Typical High $1,995.26 | Facility | None | $223.87 | $977.24 | $1,995.26 |
United Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $323.59 | Professional | None | $117.49 | $177.83 | $323.59 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $281.84 | Professional | None | $177.83 | $208.93 | $281.84 |
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 $58.88 Median $89.13 Typical High $102.33 | Professional | 52 · Reduced service | $58.88 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $23.44 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $134.90 Typical High $151.36 | Professional | 54 · Surgery only | $89.13 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.92 Typical High $30.20 | Professional | 55 · Aftercare only | $17.78 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.78 Typical High $20.42 | Professional | 56 · Pre-op care only | $11.75 | $17.78 | $20.42 |
Where Iowa sits
The same service costs 4.5 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· 4th of 51
$240
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.