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 $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $1,000.00 | Professional | None | $512.86 | $707.95 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,230.27 | Facility | None | $616.60 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,479.11 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,096.48 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $1,202.26 Typical High $5,128.61 | Facility | None | $794.33 | $1,202.26 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,122.02 Typical High $3,467.37 | Professional | None | $549.54 | $1,122.02 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,479.11 | $1,479.11 |
Midlands Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,819.70 | $1,819.70 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,090.30 | Facility | None | $1,621.81 | $1,621.81 | $3,090.30 |
United Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $977.24 | Professional | None | $489.78 | $549.54 | $977.24 |
Wellmark Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $257.04 Median $354.81 Typical High $501.19 | Professional | 52 · Reduced service | $257.04 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $141.25 Typical High $204.17 | Professional | 53 · Discontinued | $102.33 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $104.71 Typical High $151.36 | Professional | 55 · Aftercare only | $77.62 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $70.79 Typical High $100.00 | Professional | 56 · Pre-op care only | $51.29 | $70.79 | $100.00 |
Where Iowa sits
The same service costs 2.6 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· 5th of 51
$1,072
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.