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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $478.63 | Professional | None | $181.97 | $239.88 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $426.58 Typical High $426.58 | Facility | None | $208.93 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $549.54 | Professional | None | $389.05 | $501.19 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $426.58 | Professional | None | $302.00 | $380.19 | $426.58 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $1,778.28 | Facility | None | $257.04 | $416.87 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $977.24 | Professional | None | $186.21 | $323.59 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | None | $436.52 | $501.19 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $630.96 Typical High $630.96 | Professional | None | $389.05 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $1,071.52 | Facility | None | $549.54 | $549.54 | $1,071.52 |
United Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $331.13 | Professional | None | $169.82 | $186.21 | $331.13 |
Wellmark Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $89.13 Median $120.23 Typical High $173.78 | Professional | 52 · Reduced service | $89.13 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $47.86 Typical High $69.18 | Professional | 53 · Discontinued | $35.48 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $36.31 Typical High $52.48 | Professional | 55 · Aftercare only | $26.30 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.99 Typical High $34.67 | Professional | 56 · Pre-op care only | $17.78 | $23.99 | $34.67 |
Where Iowa sits
The same service costs 2.4 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
$363
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.