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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $741.31 | Professional | None | $380.19 | $478.63 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $851.14 | Facility | None | $446.68 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,096.48 | Professional | None | $776.25 | $1,071.52 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $891.25 | Professional | None | $602.56 | $758.58 | $891.25 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $3,801.89 | Facility | None | $512.86 | $831.76 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $2,089.30 | Professional | None | $371.54 | $645.65 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | None | $891.25 | $1,071.52 | $1,071.52 |
Midlands Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,258.93 | Professional | None | $831.76 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $630.96 Median $1,174.90 Typical High $2,290.87 | Facility | None | $630.96 | $1,174.90 | $2,290.87 |
United Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $660.69 | Professional | None | $354.81 | $380.19 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $190.55 Median $239.88 Typical High $371.54 | Professional | 52 · Reduced service | $190.55 | $239.88 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $97.72 Typical High $151.36 | Professional | 53 · Discontinued | $75.86 | $97.72 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $72.44 Typical High $112.20 | Professional | 55 · Aftercare only | $56.23 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $47.86 Typical High $74.13 | Professional | 56 · Pre-op care only | $38.02 | $47.86 | $74.13 |
Where Iowa sits
The same service costs 4.6 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· 10th of 51
$724
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.