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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $104.71 | Professional | None | $53.70 | $70.79 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $123.03 | Facility | None | $75.86 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $186.21 | Professional | None | $120.23 | $162.18 | $186.21 |
Hally Health Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $134.90 | Professional | None | $95.50 | $125.89 | $134.90 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $562.34 | Facility | None | $75.86 | $123.03 | $562.34 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $309.03 | Professional | None | $54.95 | $95.50 | $309.03 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $162.18 | Professional | None | $128.82 | $162.18 | $162.18 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | None | $123.03 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $72.44 Median $177.83 Typical High $338.84 | Facility | None | $72.44 | $177.83 | $338.84 |
United Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $97.72 | Professional | None | $52.48 | $54.95 | $97.72 |
Wellmark Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $26.92 Median $35.48 Typical High $52.48 | Professional | 52 · Reduced service | $26.92 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.13 Typical High $20.89 | Professional | 53 · Discontinued | $10.72 | $14.13 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.72 Typical High $15.85 | Professional | 55 · Aftercare only | $7.94 | $10.72 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.08 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.37 | $7.08 | $10.47 |
Where Iowa sits
The same service costs 3.1 times more in Hawaii than in New Jersey. 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· 6th of 51
$110
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.