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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $870.96 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $2,454.71 | Facility | None | $1,584.89 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $3,548.13 | Professional | None | $2,238.72 | $2,754.23 | $3,548.13 |
Hally Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,570.40 | Professional | None | $1,995.26 | $2,344.23 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,479.11 | $2,398.83 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $5,248.07 | Professional | None | $1,096.48 | $1,862.09 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $2,884.03 | Professional | None | $2,570.40 | $2,754.23 | $2,884.03 |
Midlands Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,089.30 | $3,630.78 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,951.21 Typical High $5,754.40 | Facility | None | $1,258.93 | $2,951.21 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,096.48 | $1,949.84 |
Wellmark Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $436.52 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $436.52 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $173.78 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $128.82 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $87.10 | $169.82 | $169.82 |
Where Iowa sits
The same service costs 2.8 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
$2,188
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.