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 $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $4,265.80 | Professional | None | $2,187.76 | $3,801.89 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $5,370.32 Typical High $5,370.32 | Facility | None | $3,548.13 | $5,370.32 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $7,943.28 | Professional | None | $5,248.07 | $7,244.36 | $7,943.28 |
Hally Health Setting Professional Modifier None Typical Low $4,677.35 Median $5,495.41 Typical High $10,000.00 | Professional | None | $4,677.35 | $5,495.41 | $10,000.00 |
Medica Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $25,703.96 | Facility | None | $3,311.31 | $5,370.32 | $25,703.96 |
Medica Setting Professional Modifier None Typical Low $2,398.83 Median $4,265.80 Typical High $14,125.38 | Professional | None | $2,398.83 | $4,265.80 | $14,125.38 |
Midlands Setting Professional Modifier None Typical Low $5,623.41 Median $7,244.36 Typical High $7,244.36 | Professional | None | $5,623.41 | $7,244.36 | $7,244.36 |
Midlands Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $5,495.41 Median $8,128.31 Typical High $8,128.31 | Professional | None | $5,495.41 | $8,128.31 | $8,128.31 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $7,943.28 Typical High $15,135.61 | Facility | None | $4,365.16 | $7,943.28 | $15,135.61 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $4,265.80 | Professional | None | $2,398.83 | $2,454.71 | $4,265.80 |
Wellmark Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
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 $1,096.48 Median $1,905.46 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,096.48 | $1,905.46 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $758.58 Typical High $851.14 | Professional | 53 · Discontinued | $446.68 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $562.34 Typical High $645.65 | Professional | 55 · Aftercare only | $331.13 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $380.19 Typical High $426.58 | Professional | 56 · Pre-op care only | $218.78 | $380.19 | $426.58 |
Where Iowa sits
The same service costs 4.3 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· 7th of 51
$4,786
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.