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 $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,071.52 | Professional | None | $562.34 | $794.33 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $1,412.54 | Facility | None | $741.31 | $1,412.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,698.24 | $1,778.28 |
Hally Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,258.93 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $1,380.38 Typical High $6,309.57 | Facility | None | $851.14 | $1,380.38 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $3,388.44 | Professional | None | $616.60 | $1,071.52 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,778.28 | $1,778.28 |
Midlands Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,348.96 | $2,089.30 | $2,089.30 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,905.46 Typical High $3,715.35 | Facility | None | $912.01 | $1,905.46 | $3,715.35 |
United Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $1,096.48 | Professional | None | $588.84 | $630.96 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $281.84 Median $398.11 Typical High $537.03 | Professional | 52 · Reduced service | $281.84 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $158.49 Typical High $213.80 | Professional | 53 · Discontinued | $112.20 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $120.23 Typical High $162.18 | Professional | 55 · Aftercare only | $83.18 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $79.43 Typical High $107.15 | Professional | 56 · Pre-op care only | $56.23 | $79.43 | $107.15 |
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· 6th of 51
$1,202
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.