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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $398.11 | Professional | None | $199.53 | $269.15 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $467.74 Typical High $467.74 | Facility | None | $316.23 | $467.74 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $707.95 | Professional | None | $457.09 | $630.96 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $562.34 | Professional | None | $354.81 | $524.81 | $562.34 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $467.74 Typical High $2,187.76 | Facility | None | $288.40 | $467.74 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $1,202.26 | Professional | None | $208.93 | $389.05 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $630.96 | Professional | None | $489.78 | $630.96 | $630.96 |
Midlands Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $707.95 | Professional | None | $478.63 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $269.15 Median $676.08 Typical High $1,318.26 | Facility | None | $269.15 | $676.08 | $1,318.26 |
United Setting Professional Modifier None Typical Low $204.17 Median $208.93 Typical High $371.54 | Professional | None | $204.17 | $208.93 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
4 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 $100.00 Median $134.90 Typical High $199.53 | Professional | 52 · Reduced service | $100.00 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $53.70 Typical High $79.43 | Professional | 53 · Discontinued | $39.81 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $40.74 Typical High $58.88 | Professional | 55 · Aftercare only | $30.20 | $40.74 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $26.92 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.95 | $26.92 | $39.81 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 7th of 51
$417
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.