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 $2,137.96 Median $2,137.96 Typical High $4,265.80 | Facility | None | $2,137.96 | $2,137.96 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,137.96 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,344.23 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,230.27 | $2,137.96 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $2,691.53 | Facility | None | $2,041.74 | $2,454.71 | $2,691.53 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,089.30 | $3,801.89 |
Midlands Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,754.23 | $2,754.23 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,238.72 | Professional | None | $2,137.96 | $2,137.96 | $2,238.72 |
Wellmark Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,071.52 Median $1,071.52 Typical High $1,621.81 | Facility | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,621.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $645.65 | Facility | 53 · Discontinued | $426.58 | $426.58 | $645.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $478.63 | Facility | 55 · Aftercare only | $323.59 | $323.59 | $478.63 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $323.59 | Facility | 56 · Pre-op care only | $213.80 | $213.80 | $323.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $436.52 Typical High $446.68 | Professional | 53 · Discontinued | $426.58 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $223.87 |
Where Iowa sits
The same service costs 2.0 times more in Arizona than in Alabama. 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· 25th of 51
$2,138
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.