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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $588.84 | Professional | None | $281.84 | $380.19 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $660.69 Typical High $660.69 | Facility | None | $416.87 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $933.25 | Professional | None | $616.60 | $831.76 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $660.69 | Professional | None | $501.19 | $588.84 | $660.69 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $2,951.21 | Facility | None | $407.38 | $645.65 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $537.03 Typical High $1,621.81 | Professional | None | $295.12 | $537.03 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $831.76 | Professional | None | $691.83 | $831.76 | $831.76 |
Midlands Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,000.00 | Professional | None | $645.65 | $1,000.00 | $1,000.00 |
United Setting Facility Modifier None Typical Low $371.54 Median $912.01 Typical High $1,737.80 | Facility | None | $371.54 | $912.01 | $1,737.80 |
United Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $524.81 | Professional | None | $275.42 | $295.12 | $524.81 |
Wellmark Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $144.54 Median $190.55 Typical High $295.12 | Professional | 52 · Reduced service | $144.54 | $190.55 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $75.86 Typical High $117.49 | Professional | 53 · Discontinued | $57.54 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $87.10 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.02 Typical High $58.88 | Professional | 56 · Pre-op care only | $28.84 | $38.02 | $58.88 |
Where Iowa sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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
$589
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.