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 $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,380.38 | Professional | None | $707.95 | $870.96 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,513.56 Typical High $1,513.56 | Facility | None | $851.14 | $1,513.56 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,995.26 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,513.56 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $7,079.46 | Facility | None | $912.01 | $1,479.11 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,288.25 Typical High $3,890.45 | Professional | None | $660.69 | $1,288.25 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
Midlands Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,548.82 | $2,238.72 | $2,238.72 |
United Setting Facility Modifier None Typical Low $776.25 Median $2,187.76 Typical High $4,265.80 | Facility | None | $776.25 | $2,187.76 | $4,265.80 |
United Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $1,202.26 | Professional | None | $660.69 | $676.08 | $1,202.26 |
Wellmark Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $363.08 Median $436.52 Typical High $691.83 | Professional | 52 · Reduced service | $363.08 | $436.52 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $281.84 | Professional | 53 · Discontinued | $144.54 | $173.78 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $208.93 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $138.04 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $138.04 |
Where Iowa sits
The same service costs 3.0 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
$1,349
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.