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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $354.81 | Professional | None | $204.17 | $234.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $524.81 | Facility | None | $380.19 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $616.60 | Professional | None | $426.58 | $524.81 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $676.08 | Professional | None | $316.23 | $371.54 | $676.08 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $512.86 Typical High $1,659.59 | Facility | None | $389.05 | $512.86 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $1,174.90 | Professional | None | $275.42 | $478.63 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | None | $524.81 | $524.81 | $562.34 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,137.96 | Facility | None | $1,122.02 | $1,122.02 | $2,137.96 |
United Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $489.78 | Professional | None | $257.04 | $275.42 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $117.49 Typical High $177.83 | Professional | 52 · Reduced service | $100.00 | $117.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $46.77 Typical High $70.79 | Professional | 53 · Discontinued | $40.74 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $35.48 Typical High $52.48 | Professional | 55 · Aftercare only | $30.20 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.44 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.42 | $23.44 | $35.48 |
Where Iowa sits
The same service costs 3.0 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
$468
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.