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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $269.15 | Professional | None | $141.25 | $190.55 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $331.13 Typical High $331.13 | Facility | None | $190.55 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $436.52 | Professional | None | $302.00 | $426.58 | $436.52 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $363.08 | Professional | None | $177.83 | $338.84 | $363.08 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $1,548.82 | Facility | None | $199.53 | $323.59 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $851.14 | Professional | None | $144.54 | $263.03 | $851.14 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $436.52 | Professional | None | $346.74 | $436.52 | $436.52 |
Midlands Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $489.78 | Professional | None | $338.84 | $489.78 | $489.78 |
United Setting Facility Modifier None Typical Low $194.98 Median $478.63 Typical High $933.25 | Facility | None | $194.98 | $478.63 | $933.25 |
United Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $263.03 | Professional | None | $141.25 | $147.91 | $263.03 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $70.79 Median $93.33 Typical High $134.90 | Professional | 52 · Reduced service | $70.79 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.02 Typical High $53.70 | Professional | 53 · Discontinued | $28.18 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.18 Typical High $40.74 | Professional | 55 · Aftercare only | $20.89 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.05 Typical High $26.92 | Professional | 56 · Pre-op care only | $14.13 | $19.05 | $26.92 |
Where Iowa sits
The same service costs 3.5 times more in Hawaii 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· 7th of 51
$295
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.