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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $398.11 | Professional | None | $199.53 | $275.42 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $478.63 Typical High $478.63 | Facility | None | $263.03 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $630.96 | Professional | None | $446.68 | $616.60 | $630.96 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $501.19 | Professional | None | $346.74 | $426.58 | $501.19 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $2,238.72 | Facility | None | $295.12 | $467.74 | $2,238.72 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $1,202.26 | Professional | None | $213.80 | $363.08 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | None | $501.19 | $616.60 | $616.60 |
Midlands Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $724.44 | Professional | None | $467.74 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $275.42 Median $676.08 Typical High $1,288.25 | Facility | None | $275.42 | $676.08 | $1,288.25 |
United Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $380.19 | Professional | None | $199.53 | $213.80 | $380.19 |
Wellmark Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $100.00 Median $138.04 Typical High $190.55 | Professional | 52 · Reduced service | $100.00 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $75.86 | Professional | 53 · Discontinued | $39.81 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $40.74 Typical High $57.54 | Professional | 55 · Aftercare only | $30.20 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.95 | $27.54 | $38.02 |
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· 4th of 51
$417
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.