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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $660.69 | Professional | None | $331.13 | $436.52 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $758.58 | Facility | None | $407.38 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,071.52 | Professional | None | $707.95 | $977.24 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $794.33 | Professional | None | $575.44 | $707.95 | $794.33 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $741.31 Typical High $3,467.37 | Facility | None | $467.74 | $741.31 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $1,905.46 | Professional | None | $331.13 | $588.84 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $977.24 | Professional | None | $794.33 | $977.24 | $977.24 |
Midlands Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,122.02 | Professional | None | $758.58 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,071.52 Typical High $2,041.74 | Facility | None | $575.44 | $1,071.52 | $2,041.74 |
United Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $616.60 | Professional | None | $316.23 | $338.84 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $165.96 Median $218.78 Typical High $331.13 | Professional | 52 · Reduced service | $165.96 | $218.78 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $87.10 Typical High $131.83 | Professional | 53 · Discontinued | $66.07 | $87.10 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $100.00 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $43.65 Typical High $66.07 | Professional | 56 · Pre-op care only | $33.11 | $43.65 | $66.07 |
Where Iowa sits
The same service costs 4.3 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· 7th of 51
$676
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.