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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,258.93 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $3,548.13 | Facility | None | $1,737.80 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $4,168.69 Typical High $4,786.30 | Professional | None | $3,235.94 | $4,168.69 | $4,786.30 |
Hally Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,311.31 Typical High $3,715.35 | Professional | None | $2,884.03 | $3,311.31 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $14,791.08 | Facility | None | $2,137.96 | $3,467.37 | $14,791.08 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $2,691.53 Typical High $8,128.31 | Professional | None | $1,584.89 | $2,691.53 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $3,715.35 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,715.35 | $4,168.69 | $4,168.69 |
Midlands Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $3,235.94 Median $5,248.07 Typical High $5,248.07 | Professional | None | $3,235.94 | $5,248.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,570.88 Typical High $8,709.64 | Facility | None | $1,621.81 | $4,570.88 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,584.89 | $2,818.38 |
Wellmark Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $645.65 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $645.65 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $257.04 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $190.55 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $128.82 | $245.47 | $245.47 |
Where Iowa sits
The same service costs 2.7 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· 2nd of 51
$3,162
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.