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 $1,905.46 Median $3,801.89 Typical High $3,801.89 | Facility | None | $1,905.46 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,754.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,454.71 | Professional | None | $1,949.84 | $2,290.87 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $4,786.30 | Professional | None | $1,479.11 | $1,819.70 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $3,801.89 | Facility | None | $1,862.09 | $2,238.72 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $6,025.60 | Professional | None | $1,862.09 | $1,995.26 | $6,025.60 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,570.40 | Professional | None | $2,398.83 | $2,398.83 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,041.74 | Professional | None | $1,862.09 | $1,862.09 | $2,041.74 |
Wellmark Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
8 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 Facility Modifier 52 · Reduced service Typical Low $954.99 Median $1,905.46 Typical High $1,905.46 | Facility | 52 · Reduced service | $954.99 | $1,905.46 | $1,905.46 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $380.19 Median $776.25 Typical High $776.25 | Facility | 53 · Discontinued | $380.19 | $776.25 | $776.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $288.40 Median $575.44 Typical High $575.44 | Facility | 55 · Aftercare only | $288.40 | $575.44 | $575.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $190.55 Median $380.19 Typical High $380.19 | Facility | 56 · Pre-op care only | $190.55 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,380.38 Typical High $1,905.46 | Professional | 52 · Reduced service | $954.99 | $1,380.38 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $549.54 Typical High $776.25 | Professional | 53 · Discontinued | $380.19 | $549.54 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $416.87 Typical High $575.44 | Professional | 55 · Aftercare only | $288.40 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $275.42 Typical High $380.19 | Professional | 56 · Pre-op care only | $190.55 | $275.42 | $380.19 |
Where Iowa sits
The same service costs 2.4 times more in Texas than in Rhode Island. 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· 42nd of 51
$1,905
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.