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 $162.18 Median $5,888.44 Typical High $7,943.28 | Facility | None | $162.18 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $177.83 | Professional | None | $141.25 | $162.18 | $177.83 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $575.44 Typical High $630.96 | Professional | None | $151.36 | $575.44 | $630.96 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $288.40 Typical High $1,548.82 | Facility | None | $154.88 | $288.40 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $1,122.02 | Professional | None | $269.15 | $416.87 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $446.68 | Professional | None | $275.42 | $416.87 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $954.99 | Facility | None | $562.34 | $676.08 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $467.74 | Professional | None | $281.84 | $302.00 | $467.74 |
Wellmark Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $338.84 | Professional | None | $269.15 | $338.84 | $338.84 |
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 $70.79 Median $81.28 Typical High $89.13 | Professional | 52 · Reduced service | $70.79 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $28.18 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $120.23 Typical High $131.83 | Professional | 54 · Surgery only | $104.71 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $26.30 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $17.78 |
Where Iowa sits
The same service costs 7.6 times more in Nebraska than in West Virginia. 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· 13th of 51
$339
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.