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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $245.47 | Professional | None | $123.03 | $218.78 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $380.19 Typical High $380.19 | Facility | None | $158.49 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $489.78 | Professional | None | $354.81 | $380.19 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $398.11 | Professional | None | $263.03 | $338.84 | $398.11 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $371.54 Typical High $1,412.54 | Facility | None | $234.42 | $371.54 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $741.31 | Professional | None | $151.36 | $295.12 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | None | $380.19 | $380.19 | $398.11 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $575.44 Typical High $575.44 | Professional | None | $295.12 | $575.44 | $575.44 |
United Setting Facility Modifier None Typical Low $169.82 Median $416.87 Typical High $812.83 | Facility | None | $169.82 | $416.87 | $812.83 |
United Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $302.00 | Professional | None | $128.82 | $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 $61.66 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $61.66 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $24.55 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $18.62 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.30 | $21.88 | $24.55 |
Where Iowa sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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
$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.