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 $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $3,311.31 Typical High $3,715.35 | Professional | None | $1,905.46 | $3,311.31 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $4,786.30 Typical High $4,786.30 | Facility | None | $2,754.23 | $4,786.30 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $6,309.57 | Professional | None | $4,365.16 | $5,888.44 | $6,309.57 |
Hally Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,365.16 Typical High $5,370.32 | Professional | None | $4,073.80 | $4,365.16 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $2,884.03 Median $4,677.35 Typical High $20,892.96 | Facility | None | $2,884.03 | $4,677.35 | $20,892.96 |
Medica Setting Professional Modifier None Typical Low $2,089.30 Median $3,715.35 Typical High $11,481.54 | Professional | None | $2,089.30 | $3,715.35 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $5,011.87 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,011.87 | $5,888.44 | $5,888.44 |
Midlands Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $4,570.88 Median $7,079.46 Typical High $7,079.46 | Professional | None | $4,570.88 | $7,079.46 | $7,079.46 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $6,456.54 Typical High $12,589.25 | Facility | None | $2,398.83 | $6,456.54 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,137.96 | $3,715.35 |
Wellmark Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
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 $954.99 Median $1,659.59 Typical High $1,862.09 | Professional | 52 · Reduced service | $954.99 | $1,659.59 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $660.69 Typical High $741.31 | Professional | 53 · Discontinued | $380.19 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $489.78 Typical High $549.54 | Professional | 55 · Aftercare only | $288.40 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $331.13 Typical High $371.54 | Professional | 56 · Pre-op care only | $190.55 | $331.13 | $371.54 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in West Virginia. 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· 6th of 51
$4,266
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.