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 $602.56 Median $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $257.04 Typical High $257.04 | Professional | None | $52.48 | $257.04 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $223.87 Typical High $446.68 | Professional | None | $50.12 | $223.87 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $269.15 | Professional | None | $114.82 | $131.83 | $269.15 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $602.56 Typical High $1,778.28 | Facility | None | $100.00 | $602.56 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $436.52 Typical High $1,288.25 | Professional | None | $218.78 | $436.52 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $446.68 | Professional | None | $223.87 | $223.87 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $446.68 Typical High $1,348.96 | Professional | None | $223.87 | $446.68 | $1,348.96 |
United Setting Facility Modifier None Typical Low $158.49 Median $954.99 Typical High $1,995.26 | Facility | None | $158.49 | $954.99 | $1,995.26 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | None | $204.17 | $204.17 | $239.88 |
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 $31.62 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $31.62 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $12.59 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $46.77 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $9.33 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $6.31 | $25.70 | $25.70 |
Where Iowa sits
The same service costs 16.6 times more in California than in Texas. 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· 12th 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.