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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $234.42 | Professional | None | $204.17 | $229.09 | $234.42 |
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 $147.91 Median $190.55 Typical High $302.00 | Professional | None | $147.91 | $190.55 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $323.59 Typical High $407.38 | Professional | None | $151.36 | $323.59 | $407.38 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $380.19 Typical High $1,380.38 | Facility | None | $316.23 | $380.19 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $1,348.96 | Professional | None | $257.04 | $263.03 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $302.00 | Professional | None | $190.55 | $190.55 | $302.00 |
Midlands Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $302.00 | Facility | None | $190.55 | $239.88 | $302.00 |
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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $102.33 Median $114.82 Typical High $117.49 | Professional | 52 · Reduced service | $102.33 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $46.77 | Professional | 53 · Discontinued | $40.74 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $34.67 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $23.44 |
Where Iowa sits
The same service costs 2.9 times more in Alaska 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· 3rd of 51
$257
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.