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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $870.96 | Professional | None | $436.52 | $562.34 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,000.00 | Facility | None | $512.86 | $1,000.00 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,412.54 | Professional | None | $933.25 | $1,230.27 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,096.48 | Professional | None | $758.58 | $977.24 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $4,365.16 | Facility | None | $602.56 | $977.24 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $2,398.83 | Professional | None | $436.52 | $794.33 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,230.27 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | None | $933.25 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,348.96 Typical High $2,570.40 | Facility | None | $549.54 | $1,348.96 | $2,570.40 |
United Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $776.25 | Professional | None | $407.38 | $446.68 | $776.25 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $218.78 Median $281.84 Typical High $436.52 | Professional | 52 · Reduced service | $218.78 | $281.84 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $112.20 Typical High $173.78 | Professional | 53 · Discontinued | $87.10 | $112.20 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $85.11 Typical High $128.82 | Professional | 55 · Aftercare only | $66.07 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $87.10 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $87.10 |
Where Iowa sits
The same service costs 3.2 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· 5th of 51
$891
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.