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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,819.70 | Professional | None | $933.25 | $1,318.26 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $2,290.87 | Facility | None | $1,174.90 | $2,290.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,089.30 | $2,630.27 | $3,090.30 |
Hally Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,398.83 | Professional | None | $1,659.59 | $2,137.96 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $9,772.37 | Facility | None | $1,412.54 | $2,238.72 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $5,128.61 | Professional | None | $1,000.00 | $1,737.80 | $5,128.61 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $2,691.53 | Professional | None | $2,398.83 | $2,630.27 | $2,691.53 |
Midlands Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,041.74 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,884.03 Typical High $5,495.41 | Facility | None | $1,479.11 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,819.70 | Professional | None | $870.96 | $1,023.29 | $1,819.70 |
Wellmark Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $467.74 Median $660.69 Typical High $912.01 | Professional | 52 · Reduced service | $467.74 | $660.69 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $263.03 Typical High $371.54 | Professional | 53 · Discontinued | $186.21 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $194.98 Typical High $275.42 | Professional | 55 · Aftercare only | $138.04 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $131.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $93.33 | $131.83 | $181.97 |
Where Iowa sits
The same service costs 4.0 times more in Hawaii than in Pennsylvania. 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
$2,042
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.