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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,584.89 Typical High $1,737.80 | Professional | None | $891.25 | $1,584.89 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $2,290.87 | Facility | None | $1,318.26 | $2,290.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,691.53 | $2,951.21 |
Hally Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,819.70 | $2,041.74 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $9,549.93 | Facility | None | $1,380.38 | $2,238.72 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $5,248.07 | Professional | None | $1,000.00 | $1,737.80 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,398.83 | $2,691.53 | $2,691.53 |
Midlands Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,089.30 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $5,754.40 | Facility | None | $2,454.71 | $2,951.21 | $5,754.40 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,778.28 | Professional | None | $954.99 | $1,023.29 | $1,778.28 |
Wellmark Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $446.68 Median $794.33 Typical High $851.14 | Professional | 52 · Reduced service | $446.68 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $316.23 Typical High $346.74 | Professional | 53 · Discontinued | $177.83 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $131.83 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $158.49 Typical High $173.78 | Professional | 56 · Pre-op care only | $89.13 | $158.49 | $173.78 |
Where Iowa sits
The same service costs 3.0 times more in Kansas 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· 6th of 51
$2,042
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.