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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $117.49 | Professional | None | $61.66 | $83.18 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $144.54 Typical High $144.54 | Facility | None | $81.28 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $190.55 | Professional | None | $131.83 | $186.21 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $151.36 | Professional | None | $102.33 | $112.20 | $151.36 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $676.08 | Facility | None | $87.10 | $141.25 | $676.08 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $114.82 Typical High $371.54 | Professional | None | $64.57 | $114.82 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $190.55 | $190.55 |
Midlands Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | None | $147.91 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $85.11 Median $208.93 Typical High $407.38 | Facility | None | $85.11 | $208.93 | $407.38 |
United Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $114.82 | Professional | None | $63.10 | $64.57 | $114.82 |
Wellmark Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $30.90 Median $41.69 Typical High $58.88 | Professional | 52 · Reduced service | $30.90 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.60 Typical High $23.44 | Professional | 53 · Discontinued | $12.30 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.30 Typical High $17.78 | Professional | 55 · Aftercare only | $9.12 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.32 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.17 | $8.32 | $11.75 |
Where Iowa sits
The same service costs 5.1 times more in Kansas than in Florida. 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· 9th of 51
$129
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.