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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $602.56 Typical High $602.56 | Professional | None | $281.84 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $870.96 Typical High $870.96 | Facility | None | $489.78 | $870.96 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,096.48 | Professional | None | $794.33 | $977.24 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $831.76 | Professional | None | $630.96 | $741.31 | $831.76 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $851.14 Typical High $3,311.31 | Facility | None | $524.81 | $851.14 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $1,905.46 | Professional | None | $389.05 | $660.69 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,023.29 | Professional | None | $912.01 | $977.24 | $1,023.29 |
Midlands Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $1,288.25 | Professional | None | $758.58 | $1,288.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,071.52 Typical High $2,041.74 | Facility | None | $323.59 | $1,071.52 | $2,041.74 |
United Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $676.08 | Professional | None | $363.08 | $389.05 | $676.08 |
Wellmark Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $141.25 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $141.25 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $57.54 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $42.66 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $28.18 | $60.26 | $60.26 |
Where Iowa sits
The same service costs 2.4 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
$776
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.