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 $95.50 Median $158.49 Typical High $6,760.83 | Facility | None | $95.50 | $158.49 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $97.72 Typical High $194.98 | Professional | None | $47.86 | $97.72 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Facility | None | $45.71 | $45.71 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $239.88 | Professional | None | $107.15 | $181.97 | $239.88 |
Hally Health Setting Professional Modifier None Typical Low $43.65 Median $117.49 Typical High $263.03 | Professional | None | $43.65 | $117.49 | $263.03 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $239.88 Typical High $1,380.38 | Facility | None | $117.49 | $239.88 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $478.63 | Professional | None | $104.71 | $177.83 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $223.87 | Professional | None | $107.15 | $181.97 | $223.87 |
Midlands Setting Facility Modifier None Typical Low $45.71 Median $48.98 Typical High $53.70 | Facility | None | $45.71 | $48.98 | $53.70 |
Midlands Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $245.47 | Professional | None | $112.20 | $144.54 | $245.47 |
United Setting Facility Modifier None Typical Low $173.78 Median $575.44 Typical High $1,995.26 | Facility | None | $173.78 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $251.19 | Professional | None | $53.70 | $114.82 | $251.19 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $190.55 | Professional | None | $83.18 | $97.72 | $190.55 |
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 $22.91 Median $38.90 Typical High $64.57 | Professional | 52 · Reduced service | $22.91 | $38.90 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $15.49 Typical High $26.30 | Professional | 53 · Discontinued | $9.33 | $15.49 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $58.88 Typical High $97.72 | Professional | 54 · Surgery only | $34.67 | $58.88 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $11.75 Typical High $19.50 | Professional | 55 · Aftercare only | $6.92 | $11.75 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.76 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.57 | $7.76 | $12.88 |
Where Iowa sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 3rd of 51
$155
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.