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 $245.47 Median $346.74 Typical High $501.19 | Professional | None | $245.47 | $346.74 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $616.60 Typical High $616.60 | Facility | None | $389.05 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $870.96 | Professional | None | $562.34 | $741.31 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $645.65 | Professional | None | $446.68 | $588.84 | $645.65 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $2,630.27 | Facility | None | $371.54 | $602.56 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $467.74 Typical High $1,445.44 | Professional | None | $269.15 | $467.74 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | None | $645.65 | $741.31 | $741.31 |
Midlands Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $912.01 | Professional | None | $562.34 | $912.01 | $912.01 |
United Setting Facility Modifier None Typical Low $426.58 Median $812.83 Typical High $1,548.82 | Facility | None | $426.58 | $812.83 | $1,548.82 |
United Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $478.63 | Professional | None | $245.47 | $275.42 | $478.63 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $123.03 Median $173.78 Typical High $251.19 | Professional | 52 · Reduced service | $123.03 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $70.79 Typical High $100.00 | Professional | 53 · Discontinued | $48.98 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $52.48 Typical High $74.13 | Professional | 55 · Aftercare only | $36.31 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $34.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $24.55 | $34.67 | $50.12 |
Where Iowa sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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
$550
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.