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 $13.18 Median $5,888.44 Typical High $7,943.28 | Facility | None | $13.18 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $13.18 Typical High $23.44 | Professional | None | $11.48 | $13.18 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $17.38 Typical High $31.62 | Professional | None | $10.72 | $17.38 | $31.62 |
Hally Health Setting Professional Modifier None Typical Low $11.48 Median $18.20 Typical High $45.71 | Professional | None | $11.48 | $18.20 | $45.71 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $20.89 Typical High $36.31 | Facility | None | $14.13 | $20.89 | $36.31 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $21.88 Typical High $85.11 | Professional | None | $14.13 | $21.88 | $85.11 |
Midlands Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $35.48 | Professional | None | $17.38 | $17.38 | $35.48 |
Midlands Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $47.86 | Professional | None | $20.89 | $26.30 | $47.86 |
United Setting Professional Modifier None Typical Low $12.88 Median $16.22 Typical High $25.70 | Professional | None | $12.88 | $16.22 | $25.70 |
Wellmark Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $16.22 | Professional | None | $13.80 | $13.80 | $16.22 |
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 $5.89 Median $6.61 Typical High $11.48 | Professional | 52 · Reduced service | $5.89 | $6.61 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.63 Typical High $4.68 | Professional | 53 · Discontinued | $2.34 | $2.63 | $4.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $10.00 Typical High $17.38 | Professional | 54 · Surgery only | $8.91 | $10.00 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.00 Typical High $3.47 | Professional | 55 · Aftercare only | $1.78 | $2.00 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.32 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.17 | $1.32 | $2.29 |
Where Iowa sits
The same service costs 3.3 times more in Alaska than in Delaware. 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· 19th of 51
$17.38
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.