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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $363.08 | Professional | None | $213.80 | $338.84 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $489.78 Typical High $489.78 | Facility | None | $275.42 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $691.83 | Professional | None | $467.74 | $645.65 | $691.83 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $707.95 | Professional | None | $426.58 | $478.63 | $707.95 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $2,344.23 | Facility | None | $302.00 | $478.63 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $1,258.93 | Professional | None | $218.78 | $407.38 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $645.65 | Professional | None | $512.86 | $645.65 | $645.65 |
Midlands Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $724.44 | Professional | None | $501.19 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $229.09 Median $707.95 Typical High $1,380.38 | Facility | None | $229.09 | $707.95 | $1,380.38 |
United Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $389.05 | Professional | None | $218.78 | $218.78 | $389.05 |
Wellmark Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $107.15 Median $169.82 Typical High $181.97 | Professional | 52 · Reduced service | $107.15 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $67.61 Typical High $72.44 | Professional | 53 · Discontinued | $42.66 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $31.62 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $33.88 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.38 | $33.88 | $36.31 |
Where Iowa sits
The same service costs 2.5 times more in Hawaii than in Florida. 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· 10th of 51
$437
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.