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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $218.78 | Professional | None | $109.65 | $147.91 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $257.04 Typical High $257.04 | Facility | None | $165.96 | $257.04 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $371.54 | Professional | None | $245.47 | $346.74 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $275.42 | Professional | None | $194.98 | $257.04 | $275.42 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $1,230.27 | Facility | None | $158.49 | $257.04 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $676.08 | Professional | None | $114.82 | $213.80 | $676.08 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $346.74 | Professional | None | $269.15 | $346.74 | $346.74 |
Midlands Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $389.05 | Professional | None | $263.03 | $389.05 | $389.05 |
United Setting Facility Modifier None Typical Low $213.80 Median $380.19 Typical High $724.44 | Facility | None | $213.80 | $380.19 | $724.44 |
United Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $204.17 | Professional | None | $112.20 | $114.82 | $204.17 |
Wellmark Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $54.95 Median $74.13 Typical High $109.65 | Professional | 52 · Reduced service | $54.95 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $29.51 Typical High $43.65 | Professional | 53 · Discontinued | $21.88 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.39 Typical High $32.36 | Professional | 55 · Aftercare only | $16.60 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.79 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.96 | $14.79 | $21.88 |
Where Iowa sits
The same service costs 4.4 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· 11th of 51
$229
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.