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 $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,202.26 | Professional | None | $616.60 | $851.14 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,479.11 Typical High $1,479.11 | Facility | None | $831.76 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,905.46 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,318.26 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $7,079.46 | Facility | None | $891.25 | $1,445.44 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $3,801.89 | Professional | None | $645.65 | $1,122.02 | $3,801.89 |
Midlands Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,949.84 | $1,949.84 |
Midlands Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,513.56 | $2,187.76 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $4,168.69 | Facility | None | $1,348.96 | $2,137.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,174.90 | Professional | None | $645.65 | $660.69 | $1,174.90 |
Wellmark Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $309.03 Median $416.87 Typical High $616.60 | Professional | 52 · Reduced service | $309.03 | $416.87 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $169.82 Typical High $245.47 | Professional | 53 · Discontinued | $123.03 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $125.89 Typical High $186.21 | Professional | 55 · Aftercare only | $93.33 | $125.89 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $85.11 Typical High $123.03 | Professional | 56 · Pre-op care only | $61.66 | $85.11 | $123.03 |
Where Iowa sits
The same service costs 5.4 times more in Hawaii than in Delaware. 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
$1,318
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.