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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $467.74 Typical High $467.74 | Professional | None | $218.78 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $676.08 Typical High $676.08 | Facility | None | $346.74 | $676.08 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $794.33 | Professional | None | $616.60 | $758.58 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $707.95 | Professional | None | $501.19 | $588.84 | $707.95 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $660.69 Typical High $2,570.40 | Facility | None | $416.87 | $660.69 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $1,445.44 | Professional | None | $302.00 | $512.86 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $794.33 | Professional | None | $707.95 | $758.58 | $794.33 |
Midlands Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $575.44 | $1,000.00 | $1,000.00 |
United Setting Facility Modifier None Typical Low $251.19 Median $812.83 Typical High $1,584.89 | Facility | None | $251.19 | $812.83 | $1,584.89 |
United Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $537.03 | Professional | None | $281.84 | $302.00 | $537.03 |
Wellmark Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $109.65 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $109.65 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $43.65 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $32.36 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $21.88 | $46.77 | $46.77 |
Where Iowa sits
The same service costs 2.9 times more in Iowa than in Kansas. 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· 1st of 51
$603
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.