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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,905.46 Typical High $1,905.46 | Professional | None | $891.25 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $2,754.23 Typical High $2,754.23 | Facility | None | $1,258.93 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $3,388.44 | Professional | None | $2,511.89 | $3,019.95 | $3,388.44 |
Hally Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,454.71 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $10,964.78 | Facility | None | $1,659.59 | $2,691.53 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $2,089.30 Typical High $5,888.44 | Professional | None | $1,230.27 | $2,089.30 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $3,235.94 | Professional | None | $2,884.03 | $3,019.95 | $3,235.94 |
Midlands Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $2,344.23 Median $4,073.80 Typical High $4,073.80 | Professional | None | $2,344.23 | $4,073.80 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,584.89 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,230.27 | $2,137.96 |
Wellmark Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $457.09 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $457.09 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $181.97 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $138.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $91.20 | $190.55 | $190.55 |
Where Iowa sits
The same service costs 3.8 times more in Hawaii than in Delaware. 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
$2,455
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.