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 $69.18 Median $69.18 Typical High $123.03 | Facility | None | $69.18 | $69.18 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $69.18 Typical High $123.03 | Professional | None | $42.66 | $69.18 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $64.57 | Facility | None | $60.26 | $60.26 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $218.78 | Professional | None | $102.33 | $144.54 | $218.78 |
Hally Health Setting Professional Modifier None Typical Low $42.66 Median $100.00 Typical High $141.25 | Professional | None | $42.66 | $100.00 | $141.25 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $190.55 Typical High $1,288.25 | Facility | None | $97.72 | $190.55 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $338.84 | Professional | None | $83.18 | $123.03 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $199.53 | Professional | None | $104.71 | $141.25 | $199.53 |
Midlands Setting Facility Modifier None Typical Low $60.26 Median $64.57 Typical High $70.79 | Facility | None | $60.26 | $64.57 | $70.79 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $173.78 | Professional | None | $53.70 | $91.20 | $173.78 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $177.83 | Professional | None | $83.18 | $93.33 | $177.83 |
4 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 $21.38 Median $34.67 Typical High $61.66 | Professional | 52 · Reduced service | $21.38 | $34.67 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $13.80 Typical High $24.55 | Professional | 53 · Discontinued | $8.51 | $13.80 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.47 Typical High $18.20 | Professional | 55 · Aftercare only | $6.46 | $10.47 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.92 Typical High $12.30 | Professional | 56 · Pre-op care only | $4.27 | $6.92 | $12.30 |
Where Iowa sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 4th of 51
$120
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.