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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $562.34 | Professional | None | $316.23 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $812.83 Typical High $812.83 | Facility | None | $426.58 | $812.83 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $954.99 | Professional | None | $741.31 | $912.01 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $851.14 | Professional | None | $602.56 | $724.44 | $851.14 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $3,235.94 | Facility | None | $489.78 | $794.33 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $1,737.80 | Professional | None | $354.81 | $616.60 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $954.99 | Professional | None | $831.76 | $912.01 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $1,202.26 Typical High $1,202.26 | Professional | None | $691.83 | $1,202.26 | $1,202.26 |
United Setting Facility Modifier None Typical Low $380.19 Median $977.24 Typical High $1,905.46 | Facility | None | $380.19 | $977.24 | $1,905.46 |
United Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $630.96 | Professional | None | $338.84 | $354.81 | $630.96 |
Wellmark Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $158.49 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $158.49 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $63.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $46.77 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $31.62 | $56.23 | $56.23 |
Where Iowa sits
The same service costs 2.7 times more in Hawaii 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· 2nd of 51
$724
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.