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 $2,570.40 Median $2,570.40 Typical High $9,549.93 | Facility | None | $2,570.40 | $2,570.40 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $3,162.28 | Professional | None | $2,570.40 | $2,951.21 | $3,162.28 |
Hally Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $5,754.40 | Professional | None | $1,819.70 | $2,691.53 | $5,754.40 |
Medica Setting Facility Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,162.28 | Facility | None | $2,454.71 | $2,884.03 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $10,715.19 | Professional | None | $2,454.71 | $2,951.21 | $10,715.19 |
Midlands Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,754.23 | $2,951.21 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $5,248.07 | Professional | None | $2,754.23 | $2,884.03 | $5,248.07 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $4,365.16 Typical High $5,248.07 | Professional | None | $2,630.27 | $4,365.16 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,570.40 | $2,884.03 |
Wellmark Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Wellmark Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $257.04 |
Where Iowa sits
Rates are fairly even across states for this service. 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· 8th of 51
$2,692
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.