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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $398.11 | Professional | None | $208.93 | $302.00 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $524.81 Typical High $524.81 | Facility | None | $346.74 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $660.69 | Professional | None | $478.63 | $645.65 | $660.69 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $562.34 | Professional | None | $371.54 | $467.74 | $562.34 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $512.86 Typical High $2,344.23 | Facility | None | $323.59 | $512.86 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $1,288.25 | Professional | None | $229.09 | $407.38 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $660.69 | Professional | None | $549.54 | $660.69 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $776.25 | Professional | None | $512.86 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $389.05 Median $724.44 Typical High $1,380.38 | Facility | None | $389.05 | $724.44 | $1,380.38 |
United Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $416.87 | Professional | None | $218.78 | $234.42 | $416.87 |
Wellmark Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $104.71 Median $151.36 Typical High $208.93 | Professional | 52 · Reduced service | $104.71 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $60.26 Typical High $83.18 | Professional | 53 · Discontinued | $41.69 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $44.67 Typical High $61.66 | Professional | 55 · Aftercare only | $31.62 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.20 Typical High $41.69 | Professional | 56 · Pre-op care only | $20.89 | $30.20 | $41.69 |
Where Iowa sits
The same service costs 3.8 times more in Hawaii than in Florida. 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
$468
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.