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 $102.33 Median $2,630.27 Typical High $6,760.83 | Facility | None | $102.33 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $102.33 | Professional | None | $54.95 | $91.20 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $158.49 | Professional | None | $69.18 | $128.82 | $158.49 |
Hally Health Setting Professional Modifier None Typical Low $46.77 Median $91.20 Typical High $239.88 | Professional | None | $46.77 | $91.20 | $239.88 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $151.36 Typical High $1,621.81 | Facility | None | $112.20 | $151.36 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $3,467.37 | Professional | None | $91.20 | $154.88 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $147.91 | Professional | None | $114.82 | $128.82 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $158.49 | Professional | None | $100.00 | $138.04 | $158.49 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,630.78 | Facility | None | $1,096.48 | $1,737.80 | $3,630.78 |
United Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $177.83 | Professional | None | $61.66 | $95.50 | $177.83 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $138.04 | Professional | None | $95.50 | $112.20 | $138.04 |
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 $26.92 Median $45.71 Typical High $51.29 | Professional | 52 · Reduced service | $26.92 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $18.20 Typical High $20.42 | Professional | 53 · Discontinued | $10.96 | $18.20 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $69.18 Typical High $75.86 | Professional | 54 · Surgery only | $40.74 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $8.13 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $9.12 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.50 | $9.12 | $10.23 |
Where Iowa sits
The same service costs 3.4 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
$120
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.