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 $194.98 Median $5,888.44 Typical High $7,943.28 | Facility | None | $194.98 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $208.93 | Professional | None | $165.96 | $194.98 | $208.93 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $676.08 Typical High $741.31 | Professional | None | $151.36 | $676.08 | $741.31 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $338.84 Typical High $1,548.82 | Facility | None | $181.97 | $338.84 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $1,348.96 | Professional | None | $323.59 | $501.19 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $512.86 | Professional | None | $331.13 | $446.68 | $512.86 |
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 $331.13 Median $363.08 Typical High $549.54 | Professional | None | $331.13 | $363.08 | $549.54 |
Wellmark Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $416.87 | Professional | None | $331.13 | $416.87 | $416.87 |
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 $83.18 Median $97.72 Typical High $104.71 | Professional | 52 · Reduced service | $83.18 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.90 Typical High $41.69 | Professional | 53 · Discontinued | $33.88 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $158.49 | Professional | 54 · Surgery only | $125.89 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $25.12 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.50 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.60 | $19.50 | $20.89 |
Where Iowa sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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
$417
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.