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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $537.03 Typical High $537.03 | Professional | None | $234.42 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $776.25 Typical High $776.25 | Facility | None | $398.11 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $954.99 | Professional | None | $707.95 | $812.83 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $812.83 | Professional | None | $549.54 | $691.83 | $812.83 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $2,818.38 | Facility | None | $467.74 | $758.58 | $2,818.38 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $588.84 Typical High $1,548.82 | Professional | None | $346.74 | $588.84 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | None | $812.83 | $812.83 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $1,148.15 | Professional | None | $616.60 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $331.13 Median $870.96 Typical High $1,698.24 | Facility | None | $331.13 | $870.96 | $1,698.24 |
United Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $616.60 | Professional | None | $316.23 | $346.74 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $117.49 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $117.49 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $47.86 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $35.48 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $23.44 | $53.70 | $53.70 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in Washington, DC. 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· 2nd of 51
$692
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.