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 $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $5,623.41 Typical High $5,623.41 | Professional | None | $2,691.53 | $5,623.41 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $8,128.31 Typical High $8,128.31 | Facility | None | $4,677.35 | $8,128.31 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $7,413.10 Median $9,120.11 Typical High $10,715.19 | Professional | None | $7,413.10 | $9,120.11 | $10,715.19 |
Hally Health Setting Professional Modifier None Typical Low $6,165.95 Median $7,244.36 Typical High $11,481.54 | Professional | None | $6,165.95 | $7,244.36 | $11,481.54 |
Medica Setting Facility Modifier None Typical Low $4,897.79 Median $7,943.28 Typical High $34,673.69 | Facility | None | $4,897.79 | $7,943.28 | $34,673.69 |
Medica Setting Professional Modifier None Typical Low $3,630.78 Median $6,165.95 Typical High $17,782.79 | Professional | None | $3,630.78 | $6,165.95 | $17,782.79 |
Midlands Setting Professional Modifier None Typical Low $8,511.38 Median $9,120.11 Typical High $9,549.93 | Professional | None | $8,511.38 | $9,120.11 | $9,549.93 |
Midlands Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $7,079.46 Median $12,022.64 Typical High $12,022.64 | Professional | None | $7,079.46 | $12,022.64 | $12,022.64 |
United Setting Facility Modifier None Typical Low $4,897.79 Median $10,000.00 Typical High $19,054.61 | Facility | None | $4,897.79 | $10,000.00 | $19,054.61 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $3,630.78 Typical High $6,309.57 | Professional | None | $3,388.44 | $3,630.78 | $6,309.57 |
Wellmark Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Professional | None | $7,244.36 | $7,244.36 | $7,244.36 |
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 $1,318.26 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $1,318.26 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $537.03 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $398.11 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $269.15 | $562.34 | $562.34 |
Where Iowa sits
The same service costs 3.9 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· 6th of 51
$7,244
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.