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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $204.17 | Professional | None | $107.15 | $144.54 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $251.19 | Facility | None | $141.25 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $338.84 | Professional | None | $234.42 | $323.59 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $263.03 | Professional | None | $151.36 | $245.47 | $263.03 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $1,258.93 | Facility | None | $154.88 | $251.19 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $660.69 | Professional | None | $112.20 | $199.53 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $338.84 | Professional | None | $263.03 | $338.84 | $338.84 |
Midlands Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $380.19 | Professional | None | $257.04 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $309.03 Median $371.54 Typical High $707.95 | Facility | None | $309.03 | $371.54 | $707.95 |
United Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $199.53 | Professional | None | $107.15 | $112.20 | $199.53 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $53.70 Median $72.44 Typical High $102.33 | Professional | 52 · Reduced service | $53.70 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.84 Typical High $40.74 | Professional | 53 · Discontinued | $21.38 | $28.84 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.88 Typical High $30.90 | Professional | 55 · Aftercare only | $16.22 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.45 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.72 | $14.45 | $20.42 |
Where Iowa sits
The same service costs 8.1 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· 6th of 51
$224
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.