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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $275.42 | Professional | None | $141.25 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $363.08 | Facility | None | $186.21 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $446.68 | Professional | None | $331.13 | $436.52 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $549.54 | Professional | None | $257.04 | $323.59 | $549.54 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $1,584.89 | Facility | None | $218.78 | $354.81 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $870.96 | Professional | None | $158.49 | $275.42 | $870.96 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $446.68 | Professional | None | $380.19 | $446.68 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $537.03 | Professional | None | $346.74 | $537.03 | $537.03 |
United Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $954.99 | Facility | None | $263.03 | $489.78 | $954.99 |
United Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $281.84 | Professional | None | $147.91 | $162.18 | $281.84 |
Wellmark Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $70.79 Median $102.33 Typical High $138.04 | Professional | 52 · Reduced service | $70.79 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $28.18 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $40.74 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $27.54 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $27.54 |
Where Iowa sits
The same service costs 5.0 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
$309
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.