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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $245.47 | Professional | None | $144.54 | $165.96 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $380.19 Typical High $380.19 | Facility | None | $275.42 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $446.68 | Professional | None | $295.12 | $380.19 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $426.58 | Professional | None | $223.87 | $257.04 | $426.58 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $371.54 Typical High $1,148.15 | Facility | None | $295.12 | $371.54 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $870.96 | Professional | None | $204.17 | $354.81 | $870.96 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | None | $380.19 | $380.19 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $954.99 | Facility | None | $501.19 | $501.19 | $954.99 |
United Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $363.08 | Professional | None | $186.21 | $208.93 | $363.08 |
Wellmark Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $72.44 Median $83.18 Typical High $123.03 | Professional | 52 · Reduced service | $72.44 | $83.18 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $48.98 | Professional | 53 · Discontinued | $28.84 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $24.55 Typical High $37.15 | Professional | 55 · Aftercare only | $21.88 | $24.55 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $24.55 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 3rd of 51
$339
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.