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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $436.52 | Professional | None | $218.78 | $309.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $549.54 Typical High $549.54 | Facility | None | $354.81 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $724.44 | Professional | None | $501.19 | $691.83 | $724.44 |
Hally Health Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $1,023.29 | Professional | None | $389.05 | $501.19 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $2,454.71 | Facility | None | $331.13 | $537.03 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $416.87 Typical High $1,318.26 | Professional | None | $239.88 | $416.87 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $691.83 | Professional | None | $562.34 | $691.83 | $691.83 |
Midlands Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $812.83 | Professional | None | $524.81 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $309.03 Median $758.58 Typical High $1,445.44 | Facility | None | $309.03 | $758.58 | $1,445.44 |
United Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $426.58 | Professional | None | $229.09 | $239.88 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $109.65 Median $154.88 Typical High $213.80 | Professional | 52 · Reduced service | $109.65 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $61.66 Typical High $87.10 | Professional | 53 · Discontinued | $43.65 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $46.77 Typical High $64.57 | Professional | 55 · Aftercare only | $33.11 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $30.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $21.88 | $30.90 | $43.65 |
Where Iowa sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 9th of 51
$468
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.