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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $134.90 | Professional | None | $69.18 | $114.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $199.53 Typical High $199.53 | Facility | None | $102.33 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $239.88 | Professional | None | $181.97 | $213.80 | $239.88 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $218.78 | Professional | None | $134.90 | $158.49 | $218.78 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $199.53 Typical High $741.31 | Facility | None | $123.03 | $199.53 | $741.31 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $154.88 Typical High $407.38 | Professional | None | $83.18 | $154.88 | $407.38 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $239.88 | Professional | None | $208.93 | $213.80 | $239.88 |
Midlands Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $302.00 | Professional | None | $162.18 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $446.68 | Facility | None | $190.55 | $229.09 | $446.68 |
United Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $158.49 | Professional | None | $70.79 | $89.13 | $158.49 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $33.88 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $33.88 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $13.80 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $10.23 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.76 | $11.48 | $13.80 |
Where Iowa sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 3rd of 51
$178
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.