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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $588.84 | Professional | None | $302.00 | $407.38 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $724.44 Typical High $724.44 | Facility | None | $398.11 | $724.44 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,071.52 | Professional | None | $707.95 | $954.99 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $977.24 | Professional | None | $549.54 | $812.83 | $977.24 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $3,388.44 | Facility | None | $436.52 | $707.95 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $602.56 Typical High $1,862.09 | Professional | None | $316.23 | $602.56 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $954.99 | Professional | None | $741.31 | $954.99 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,071.52 | Professional | None | $741.31 | $1,071.52 | $1,071.52 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,047.13 Typical High $1,995.26 | Facility | None | $331.13 | $1,047.13 | $1,995.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $588.84 | Professional | None | $316.23 | $316.23 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $151.36 Median $204.17 Typical High $295.12 | Professional | 52 · Reduced service | $151.36 | $204.17 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $81.28 Typical High $117.49 | Professional | 53 · Discontinued | $60.26 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $61.66 Typical High $87.10 | Professional | 55 · Aftercare only | $45.71 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $40.74 Typical High $58.88 | Professional | 56 · Pre-op care only | $30.20 | $40.74 | $58.88 |
Where Iowa sits
The same service costs 3.0 times more in Montana 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· 8th of 51
$646
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.