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 $323.59 Median $2,630.27 Typical High $6,760.83 | Facility | None | $323.59 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $323.59 | Professional | None | $169.82 | $275.42 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $436.52 Typical High $933.25 | Professional | None | $234.42 | $436.52 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $831.76 | Professional | None | $165.96 | $288.40 | $831.76 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $602.56 Typical High $1,348.96 | Facility | None | $302.00 | $602.56 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,621.81 | Professional | None | $416.87 | $776.25 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $1,071.52 | Professional | None | $234.42 | $467.74 | $1,071.52 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,096.48 | Professional | None | $478.63 | $660.69 | $1,096.48 |
United Setting Facility Modifier None Typical Low $223.87 Median $977.24 Typical High $1,995.26 | Facility | None | $223.87 | $977.24 | $1,995.26 |
United Setting Professional Modifier None Typical Low $239.88 Median $575.44 Typical High $1,288.25 | Professional | None | $239.88 | $575.44 | $1,288.25 |
Wellmark Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $575.44 | Professional | None | $245.47 | $288.40 | $575.44 |
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 $85.11 Median $102.33 Typical High $162.18 | Professional | 52 · Reduced service | $85.11 | $102.33 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $40.74 Typical High $64.57 | Professional | 53 · Discontinued | $33.88 | $40.74 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $154.88 Typical High $239.88 | Professional | 54 · Surgery only | $125.89 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.90 Typical High $47.86 | Professional | 55 · Aftercare only | $25.70 | $30.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.42 Typical High $32.36 | Professional | 56 · Pre-op care only | $16.98 | $20.42 | $32.36 |
Where Iowa sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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
$501
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.