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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,621.81 Typical High $1,621.81 | Professional | None | $758.58 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,380.38 | $2,344.23 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,630.27 | $3,090.30 |
Hally Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,398.83 | Professional | None | $1,737.80 | $2,137.96 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $2,290.87 Typical High $9,332.54 | Facility | None | $1,412.54 | $2,290.87 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,778.28 Typical High $5,011.87 | Professional | None | $1,023.29 | $1,778.28 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $2,754.23 | Professional | None | $2,454.71 | $2,630.27 | $2,754.23 |
Midlands Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $1,995.26 Median $3,467.37 Typical High $3,467.37 | Professional | None | $1,995.26 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,884.03 Typical High $5,495.41 | Facility | None | $1,047.13 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,819.70 | Professional | None | $977.24 | $1,023.29 | $1,819.70 |
Wellmark Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $380.19 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $380.19 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $151.36 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $114.82 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $75.86 | $162.18 | $162.18 |
Where Iowa sits
The same service costs 2.5 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· 3rd of 51
$2,089
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.