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 $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,754.40 | $5,754.40 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $5,754.40 Typical High $5,754.40 | Professional | None | $2,691.53 | $5,754.40 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $8,317.64 Typical High $8,317.64 | Facility | None | $4,897.79 | $8,317.64 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $7,585.78 Median $9,332.54 Typical High $10,964.78 | Professional | None | $7,585.78 | $9,332.54 | $10,964.78 |
Hally Health Setting Professional Modifier None Typical Low $6,165.95 Median $7,585.78 Typical High $10,471.29 | Professional | None | $6,165.95 | $7,585.78 | $10,471.29 |
Medica Setting Facility Modifier None Typical Low $5,011.87 Median $8,128.31 Typical High $33,113.11 | Facility | None | $5,011.87 | $8,128.31 | $33,113.11 |
Medica Setting Professional Modifier None Typical Low $3,630.78 Median $6,309.57 Typical High $17,782.79 | Professional | None | $3,630.78 | $6,309.57 | $17,782.79 |
Midlands Setting Professional Modifier None Typical Low $8,511.38 Median $9,332.54 Typical High $9,772.37 | Professional | None | $8,511.38 | $9,332.54 | $9,772.37 |
Midlands Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
Midlands Setting Professional Modifier None Typical Low $7,079.46 Median $12,302.69 Typical High $12,302.69 | Professional | None | $7,079.46 | $12,302.69 | $12,302.69 |
United Setting Facility Modifier None Typical Low $5,370.32 Median $10,000.00 Typical High $19,498.45 | Facility | None | $5,370.32 | $10,000.00 | $19,498.45 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $3,630.78 Typical High $6,456.54 | Professional | None | $3,467.37 | $3,630.78 | $6,456.54 |
Wellmark Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
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 $1,348.96 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,348.96 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $537.03 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $407.38 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $269.15 | $575.44 | $575.44 |
Where Iowa sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 5th of 51
$7,413
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.