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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $302.00 | Professional | None | $154.88 | $275.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $398.11 Typical High $398.11 | Facility | None | $269.15 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $588.84 | Professional | None | $389.05 | $501.19 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $457.09 | Professional | None | $346.74 | $407.38 | $457.09 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $1,737.80 | Facility | None | $245.47 | $389.05 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $977.24 | Professional | None | $177.83 | $309.03 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | None | $416.87 | $501.19 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $602.56 | Professional | None | $389.05 | $602.56 | $602.56 |
United Setting Facility Modifier None Typical Low $173.78 Median $549.54 Typical High $1,071.52 | Facility | None | $173.78 | $549.54 | $1,071.52 |
United Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $316.23 | Professional | None | $169.82 | $181.97 | $316.23 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $77.62 Median $138.04 Typical High $151.36 | Professional | 52 · Reduced service | $77.62 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $56.23 Typical High $60.26 | Professional | 53 · Discontinued | $30.90 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $23.44 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $15.49 | $27.54 | $30.20 |
Where Iowa sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 4th of 51
$355
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.