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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $316.23 | Professional | None | $169.82 | $194.98 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $457.09 | Facility | None | $302.00 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $537.03 | Professional | None | $354.81 | $457.09 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $616.60 | Professional | None | $263.03 | $302.00 | $616.60 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $446.68 Typical High $1,348.96 | Facility | None | $346.74 | $446.68 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $1,047.13 | Professional | None | $245.47 | $426.58 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | None | $457.09 | $457.09 | $489.78 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $1,148.15 | Facility | None | $588.84 | $588.84 | $1,148.15 |
United Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $436.52 | Professional | None | $218.78 | $245.47 | $436.52 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $85.11 Median $97.72 Typical High $144.54 | Professional | 52 · Reduced service | $85.11 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.90 Typical High $58.88 | Professional | 53 · Discontinued | $34.67 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.50 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.98 | $19.50 | $29.51 |
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· 4th of 51
$407
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.