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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $114.82 | Professional | None | $57.54 | $61.66 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $109.65 | Facility | None | $83.18 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $162.18 | Professional | None | $107.15 | $144.54 | $162.18 |
Hally Health Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $128.82 | Professional | None | $93.33 | $114.82 | $128.82 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $524.81 | Facility | None | $66.07 | $107.15 | $524.81 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $97.72 Typical High $281.84 | Professional | None | $47.86 | $97.72 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | None | $114.82 | $144.54 | $144.54 |
Midlands Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $162.18 | Professional | None | $112.20 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $72.44 Median $158.49 Typical High $309.03 | Facility | None | $72.44 | $158.49 | $309.03 |
United Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $87.10 | Professional | None | $46.77 | $48.98 | $87.10 |
Wellmark Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $28.84 Median $30.90 Typical High $57.54 | Professional | 52 · Reduced service | $28.84 | $30.90 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.59 Typical High $22.91 | Professional | 53 · Discontinued | $11.48 | $12.59 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.33 Typical High $17.38 | Professional | 55 · Aftercare only | $8.71 | $9.33 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $11.48 |
Where Iowa sits
The same service costs 3.5 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· 13th of 51
$97.72
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.