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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $501.19 | Professional | None | $263.03 | $346.74 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $602.56 Typical High $602.56 | Facility | None | $338.84 | $602.56 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $851.14 | Professional | None | $575.44 | $794.33 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $645.65 | Professional | None | $457.09 | $588.84 | $645.65 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $2,884.03 | Facility | None | $363.08 | $588.84 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $1,548.82 | Professional | None | $269.15 | $501.19 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $794.33 | Professional | None | $630.96 | $794.33 | $794.33 |
Midlands Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $891.25 | Professional | None | $616.60 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $1,698.24 | Facility | None | $407.38 | $870.96 | $1,698.24 |
United Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $489.78 | Professional | None | $263.03 | $269.15 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $128.82 Median $169.82 Typical High $251.19 | Professional | 52 · Reduced service | $128.82 | $169.82 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $69.18 Typical High $100.00 | Professional | 53 · Discontinued | $52.48 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $51.29 Typical High $74.13 | Professional | 55 · Aftercare only | $38.90 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $34.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $26.30 | $34.67 | $50.12 |
Where Iowa sits
The same service costs 4.2 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· 9th of 51
$537
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.