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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $407.38 | Professional | None | $177.83 | $213.80 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $380.19 Typical High $380.19 | Facility | None | $218.78 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $501.19 | Professional | None | $371.54 | $489.78 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $446.68 | Professional | None | $269.15 | $346.74 | $446.68 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $1,737.80 | Facility | None | $229.09 | $371.54 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $977.24 | Professional | None | $169.82 | $323.59 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | None | $398.11 | $501.19 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $562.34 | Professional | None | $389.05 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $169.82 Median $549.54 Typical High $1,071.52 | Facility | None | $169.82 | $549.54 | $1,071.52 |
United Setting Professional Modifier None Typical Low $165.96 Median $169.82 Typical High $302.00 | Professional | None | $165.96 | $169.82 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $91.20 Median $107.15 Typical High $204.17 | Professional | 52 · Reduced service | $91.20 | $107.15 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $43.65 Typical High $81.28 | Professional | 53 · Discontinued | $36.31 | $43.65 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $32.36 Typical High $61.66 | Professional | 55 · Aftercare only | $26.92 | $32.36 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $40.74 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $40.74 |
Where Iowa sits
The same service costs 3.6 times more in Georgia than in Alaska. 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· 5th of 51
$339
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.