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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $380.19 | Professional | None | $269.15 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $912.01 | Professional | None | $371.54 | $660.69 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $239.88 | Professional | None | $173.78 | $186.21 | $239.88 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $1,023.29 | Facility | None | $489.78 | $602.56 | $1,023.29 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $630.96 Typical High $3,388.44 | Professional | None | $257.04 | $630.96 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,047.13 | Professional | None | $660.69 | $660.69 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,096.48 | Professional | None | $776.25 | $912.01 | $1,096.48 |
United Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $457.09 | Professional | None | $234.42 | $257.04 | $457.09 |
Wellmark Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $134.90 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $134.90 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $53.70 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $40.74 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $26.92 | $38.02 | $38.02 |
Where Iowa sits
The same service costs 17.0 times more in Iowa than in Kentucky. 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· 1st of 51
$631
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.