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 $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $3,630.78 Typical High $3,981.07 | Professional | None | $1,949.84 | $3,630.78 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $5,248.07 Typical High $5,248.07 | Facility | None | $3,019.95 | $5,248.07 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $5,888.44 Typical High $7,413.10 | Professional | None | $4,897.79 | $5,888.44 | $7,413.10 |
Hally Health Setting Professional Modifier None Typical Low $4,677.35 Median $5,128.61 Typical High $6,025.60 | Professional | None | $4,677.35 | $5,128.61 | $6,025.60 |
Medica Setting Facility Modifier None Typical Low $3,311.31 Median $5,128.61 Typical High $20,892.96 | Facility | None | $3,311.31 | $5,128.61 | $20,892.96 |
Medica Setting Professional Modifier None Typical Low $2,344.23 Median $3,981.07 Typical High $11,481.54 | Professional | None | $2,344.23 | $3,981.07 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $5,495.41 Median $5,888.44 Typical High $6,165.95 | Professional | None | $5,495.41 | $5,888.44 | $6,165.95 |
Midlands Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $4,570.88 Median $7,943.28 Typical High $7,943.28 | Professional | None | $4,570.88 | $7,943.28 | $7,943.28 |
United Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $12,302.69 | Facility | None | $6,456.54 | $6,456.54 | $12,302.69 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $4,168.69 | Professional | None | $2,187.76 | $2,344.23 | $4,168.69 |
Wellmark Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
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 $977.24 Median $1,819.70 Typical High $1,995.26 | Professional | 52 · Reduced service | $977.24 | $1,819.70 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $741.31 Typical High $794.33 | Professional | 53 · Discontinued | $398.11 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $549.54 Typical High $588.84 | Professional | 55 · Aftercare only | $295.12 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $363.08 Typical High $398.11 | Professional | 56 · Pre-op care only | $194.98 | $363.08 | $398.11 |
Where Iowa sits
The same service costs 2.4 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· 5th of 51
$4,677
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.