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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $138.04 | Professional | None | $72.44 | $97.72 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $173.78 Typical High $173.78 | Facility | None | $97.72 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $257.04 | Professional | None | $169.82 | $223.87 | $257.04 |
Hally Health Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $177.83 | Professional | None | $131.83 | $151.36 | $177.83 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $169.82 Typical High $812.83 | Facility | None | $104.71 | $169.82 | $812.83 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $151.36 Typical High $436.52 | Professional | None | $75.86 | $151.36 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $223.87 | Professional | None | $177.83 | $223.87 | $223.87 |
Midlands Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | None | $173.78 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $100.00 Median $245.47 Typical High $478.63 | Facility | None | $100.00 | $245.47 | $478.63 |
United Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $134.90 | Professional | None | $74.13 | $75.86 | $134.90 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $35.48 Median $48.98 Typical High $69.18 | Professional | 52 · Reduced service | $35.48 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $19.50 Typical High $27.54 | Professional | 53 · Discontinued | $14.45 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $14.79 Typical High $20.42 | Professional | 55 · Aftercare only | $10.72 | $14.79 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.77 Typical High $13.80 | Professional | 56 · Pre-op care only | $7.24 | $9.77 | $13.80 |
Where Iowa sits
The same service costs 3.2 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· 10th of 51
$155
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.