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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,047.13 | Professional | None | $537.03 | $660.69 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,148.15 | Facility | None | $707.95 | $1,148.15 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,548.82 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,380.38 | Professional | None | $870.96 | $1,122.02 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $1,122.02 Typical High $5,495.41 | Facility | None | $707.95 | $1,122.02 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $2,951.21 | Professional | None | $512.86 | $954.99 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,548.82 | $1,548.82 |
Midlands Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,659.59 Typical High $3,235.94 | Facility | None | $691.83 | $1,659.59 | $3,235.94 |
United Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $912.01 | Professional | None | $501.19 | $512.86 | $912.01 |
Wellmark Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $269.15 Median $331.13 Typical High $512.86 | Professional | 52 · Reduced service | $269.15 | $331.13 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $131.83 Typical High $204.17 | Professional | 53 · Discontinued | $107.15 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $97.72 Typical High $154.88 | Professional | 55 · Aftercare only | $79.43 | $97.72 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $66.07 Typical High $102.33 | Professional | 56 · Pre-op care only | $53.70 | $66.07 | $102.33 |
Where Iowa sits
The same service costs 3.4 times more in Hawaii than in Mississippi. 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· 9th of 51
$1,023
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.