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 $3,890.45 Median $4,168.69 Typical High $5,754.40 | Facility | None | $3,890.45 | $4,168.69 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $4,168.69 Typical High $4,677.35 | Professional | None | $3,890.45 | $4,168.69 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $3,981.07 Typical High $5,011.87 | Professional | None | $3,890.45 | $3,981.07 | $5,011.87 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $3,630.78 Typical High $4,897.79 | Professional | None | $1,288.25 | $3,630.78 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $4,570.88 | Facility | None | $1,071.52 | $4,265.80 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $6,606.93 | Professional | None | $2,884.03 | $3,630.78 | $6,606.93 |
Midlands Setting Professional Modifier None Typical Low $3,890.45 Median $4,897.79 Typical High $4,897.79 | Professional | None | $3,890.45 | $4,897.79 | $4,897.79 |
United Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
United Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,073.80 | Professional | None | $3,801.89 | $3,801.89 | $4,073.80 |
Wellmark Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
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 $1,949.84 Median $2,041.74 Typical High $2,884.03 | Facility | 52 · Reduced service | $1,949.84 | $2,041.74 | $2,884.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $794.33 Median $831.76 Typical High $1,148.15 | Facility | 53 · Discontinued | $794.33 | $831.76 | $1,148.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $588.84 Median $616.60 Typical High $870.96 | Facility | 55 · Aftercare only | $588.84 | $616.60 | $870.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $389.05 Median $416.87 Typical High $575.44 | Facility | 56 · Pre-op care only | $389.05 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,949.84 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $794.33 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $588.84 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $389.05 | $416.87 | $416.87 |
Where Iowa sits
The same service costs 11.0 times more in Alabama than in Oklahoma. 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· 47th of 51
$3,802
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.