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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $257.04 | Professional | None | $128.82 | $173.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $309.03 Typical High $309.03 | Facility | None | $169.82 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $407.38 | Professional | None | $281.84 | $407.38 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $338.84 | Professional | None | $229.09 | $281.84 | $338.84 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $302.00 Typical High $1,445.44 | Facility | None | $186.21 | $302.00 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $794.33 | Professional | None | $138.04 | $239.88 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $407.38 | Professional | None | $323.59 | $407.38 | $407.38 |
Midlands Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $457.09 | Professional | None | $316.23 | $457.09 | $457.09 |
United Setting Facility Modifier None Typical Low $229.09 Median $446.68 Typical High $851.14 | Facility | None | $229.09 | $446.68 | $851.14 |
United Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $239.88 | Professional | None | $134.90 | $138.04 | $239.88 |
Wellmark Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $64.57 Median $87.10 Typical High $128.82 | Professional | 52 · Reduced service | $64.57 | $87.10 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $34.67 Typical High $51.29 | Professional | 53 · Discontinued | $25.70 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $26.30 Typical High $38.90 | Professional | 55 · Aftercare only | $19.50 | $26.30 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.88 | $17.38 | $25.70 |
Where Iowa sits
The same service costs 4.7 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· 8th of 51
$275
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.