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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,513.56 | $1,513.56 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $269.15 | Facility | None | $190.55 | $239.88 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $416.87 | Professional | None | $151.36 | $190.55 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $199.53 Median $1,659.59 Typical High $2,511.89 | Professional | None | $199.53 | $1,659.59 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $1,548.82 Typical High $2,754.23 | Facility | None | $389.05 | $1,548.82 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $1,659.59 Typical High $5,888.44 | Professional | None | $389.05 | $1,659.59 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $316.23 | Professional | None | $151.36 | $190.55 | $316.23 |
Midlands Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $302.00 | Facility | None | $190.55 | $239.88 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | None | $125.89 | $125.89 | $134.90 |
Wellmark Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Wellmark Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $758.58 Median $758.58 Typical High $812.83 | Professional | 52 · Reduced service | $758.58 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | 53 · Discontinued | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $165.96 |
Where Iowa sits
The same service costs 15.1 times more in Arkansas than in North Carolina. 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
$1,514
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.