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 $1,584.89 Median $1,584.89 Typical High $2,754.23 | Facility | None | $1,584.89 | $1,584.89 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,862.09 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $2,344.23 | Professional | None | $1,905.46 | $2,187.76 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,819.70 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $2,344.23 | Facility | None | $1,445.44 | $2,137.96 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,041.74 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,187.76 | $2,344.23 | $2,344.23 |
United 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 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,137.96 | Professional | None | $1,819.70 | $2,041.74 | $2,137.96 |
Wellmark Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $794.33 Median $794.33 Typical High $1,380.38 | Facility | 52 · Reduced service | $794.33 | $794.33 | $1,380.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $549.54 | Facility | 53 · Discontinued | $316.23 | $316.23 | $549.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $407.38 | Facility | 55 · Aftercare only | $239.88 | $239.88 | $407.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $275.42 | Facility | 56 · Pre-op care only | $158.49 | $158.49 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $933.25 Typical High $954.99 | Professional | 52 · Reduced service | $794.33 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $371.54 Typical High $380.19 | Professional | 53 · Discontinued | $316.23 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $281.84 Typical High $288.40 | Professional | 55 · Aftercare only | $239.88 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $186.21 Typical High $190.55 | Professional | 56 · Pre-op care only | $158.49 | $186.21 | $190.55 |
Where Iowa sits
The same service costs 3.2 times more in Alabama than in Hawaii. 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· 49th of 51
$1,820
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.