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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,548.82 | Professional | None | $812.83 | $1,122.02 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,148.15 | $1,949.84 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,570.40 | Professional | None | $1,778.28 | $2,238.72 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,778.28 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $7,943.28 | Facility | None | $1,202.26 | $1,905.46 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,479.11 Typical High $4,265.80 | Professional | None | $851.14 | $1,479.11 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $2,290.87 | Professional | None | $2,041.74 | $2,238.72 | $2,290.87 |
Midlands Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,698.24 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,398.83 Typical High $4,677.35 | Facility | None | $1,258.93 | $2,398.83 | $4,677.35 |
United Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,548.82 | Professional | None | $741.31 | $870.96 | $1,548.82 |
Wellmark Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $398.11 Median $562.34 Typical High $776.25 | Professional | 52 · Reduced service | $398.11 | $562.34 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $223.87 Typical High $309.03 | Professional | 53 · Discontinued | $162.18 | $223.87 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $165.96 Typical High $229.09 | Professional | 55 · Aftercare only | $120.23 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $112.20 Typical High $154.88 | Professional | 56 · Pre-op care only | $81.28 | $112.20 | $154.88 |
Where Iowa sits
The same service costs 3.9 times more in Hawaii than in West Virginia. 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· 3rd of 51
$1,738
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.