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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $323.59 | Professional | None | $173.78 | $295.12 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $426.58 Typical High $426.58 | Facility | None | $245.47 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $575.44 | Professional | None | $389.05 | $549.54 | $575.44 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $549.54 | Professional | None | $371.54 | $407.38 | $549.54 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $416.87 Typical High $1,995.26 | Facility | None | $263.03 | $416.87 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $1,096.48 | Professional | None | $190.55 | $338.84 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $575.44 | Professional | None | $446.68 | $575.44 | $575.44 |
Midlands Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $630.96 | Professional | None | $436.52 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $245.47 Median $616.60 Typical High $1,202.26 | Facility | None | $245.47 | $616.60 | $1,202.26 |
United Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $338.84 | Professional | None | $190.55 | $190.55 | $338.84 |
Wellmark Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $93.33 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $93.33 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $37.15 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $28.18 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $18.62 | $29.51 | $32.36 |
Where Iowa sits
The same service costs 2.5 times more in Kansas 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· 6th of 51
$380
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.