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 $380.19 Median $5,888.44 Typical High $7,943.28 | Facility | None | $380.19 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $389.05 | Professional | None | $338.84 | $380.19 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $6,165.95 Typical High $7,762.47 | Facility | None | $3,715.35 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $891.25 | Professional | None | $398.11 | $537.03 | $891.25 |
Hally Health Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $380.19 | Professional | None | $281.84 | $331.13 | $380.19 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $4,677.35 Typical High $15,135.61 | Facility | None | $446.68 | $4,677.35 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $2,290.87 | Professional | None | $457.09 | $602.56 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,000.00 | Professional | None | $537.03 | $537.03 | $1,000.00 |
Midlands Setting Facility Modifier None Typical Low $3,715.35 Median $6,165.95 Typical High $7,762.47 | Facility | None | $3,715.35 | $6,165.95 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,513.56 | Professional | None | $794.33 | $891.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $1,000.00 | Professional | None | $371.54 | $588.84 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | None | $416.87 | $416.87 | $489.78 |
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 $169.82 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $38.90 |
Where Iowa sits
The same service costs 4.5 times more in Alaska than in New York. 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· 14th of 51
$537
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.