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 $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,621.81 | Professional | None | $707.95 | $954.99 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,698.24 Typical High $1,698.24 | Facility | None | $891.25 | $1,698.24 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,995.26 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,513.56 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $7,413.10 | Facility | None | $1,023.29 | $1,659.59 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,318.26 Typical High $3,981.07 | Professional | None | $741.31 | $1,318.26 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,778.28 | $2,041.74 | $2,041.74 |
Midlands Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,584.89 | $2,511.89 | $2,511.89 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,238.72 Typical High $4,265.80 | Facility | None | $870.96 | $2,238.72 | $4,265.80 |
United Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,318.26 | Professional | None | $691.83 | $758.58 | $1,318.26 |
Wellmark Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $354.81 Median $478.63 Typical High $812.83 | Professional | 52 · Reduced service | $354.81 | $478.63 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $190.55 Typical High $323.59 | Professional | 53 · Discontinued | $141.25 | $190.55 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $144.54 Typical High $245.47 | Professional | 55 · Aftercare only | $104.71 | $144.54 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $95.50 Typical High $162.18 | Professional | 56 · Pre-op care only | $70.79 | $95.50 | $162.18 |
Where Iowa sits
The same service costs 3.0 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· 4th of 51
$1,514
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.