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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,659.59 Typical High $1,659.59 | Professional | None | $776.25 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,230.27 | $2,344.23 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,570.40 | $2,818.38 |
Hally Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,737.80 | $2,089.30 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $9,332.54 | Facility | None | $1,445.44 | $2,290.87 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,819.70 Typical High $5,011.87 | Professional | None | $1,047.13 | $1,819.70 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,454.71 | $2,570.40 | $2,818.38 |
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 $3,548.13 Typical High $3,548.13 | Professional | None | $1,995.26 | $3,548.13 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,818.38 Typical High $5,370.32 | Facility | None | $1,148.15 | $2,818.38 | $5,370.32 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,862.09 | Professional | None | $977.24 | $1,047.13 | $1,862.09 |
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 $389.05 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $389.05 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $154.88 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $117.49 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $77.62 | $165.96 | $165.96 |
Where Iowa sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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.