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 $33.88 Median $5,011.87 Typical High $7,943.28 | Facility | None | $33.88 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $43.65 Typical High $60.26 | Professional | None | $28.18 | $43.65 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $70.79 Typical High $128.82 | Professional | None | $40.74 | $70.79 | $128.82 |
Hally Health Setting Professional Modifier None Typical Low $30.20 Median $53.70 Typical High $109.65 | Professional | None | $30.20 | $53.70 | $109.65 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $100.00 Typical High $1,348.96 | Facility | None | $47.86 | $100.00 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $204.17 | Professional | None | $54.95 | $95.50 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $144.54 | Professional | None | $40.74 | $75.86 | $144.54 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $134.90 | Professional | None | $63.10 | $89.13 | $134.90 |
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 |
United Setting Professional Modifier None Typical Low $43.65 Median $75.86 Typical High $128.82 | Professional | None | $43.65 | $75.86 | $128.82 |
Wellmark Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $69.18 | Professional | None | $32.36 | $38.02 | $69.18 |
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 $15.14 Median $19.05 Typical High $26.92 | Professional | 52 · Reduced service | $15.14 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $7.59 Typical High $10.72 | Professional | 53 · Discontinued | $6.03 | $7.59 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $28.84 Typical High $39.81 | Professional | 54 · Surgery only | $22.39 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.75 Typical High $7.94 | Professional | 55 · Aftercare only | $4.47 | $5.75 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.80 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.02 | $3.80 | $5.37 |
Where Iowa sits
The same service costs 2.8 times more in Alaska than in California. 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· 6th of 51
$75.86
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.