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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $512.86 | Professional | None | $263.03 | $457.09 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $660.69 Typical High $660.69 | Facility | None | $501.19 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $977.24 | Professional | None | $645.65 | $870.96 | $977.24 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $776.25 | Professional | None | $562.34 | $660.69 | $776.25 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $645.65 Typical High $3,090.30 | Facility | None | $398.11 | $645.65 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $1,698.24 | Professional | None | $288.40 | $512.86 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $870.96 | Professional | None | $676.08 | $870.96 | $870.96 |
Midlands Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $977.24 | Professional | None | $676.08 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $389.05 Median $954.99 Typical High $1,819.70 | Facility | None | $389.05 | $954.99 | $1,819.70 |
United Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $512.86 | Professional | None | $288.40 | $295.12 | $512.86 |
Wellmark Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $131.83 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $131.83 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $52.48 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $39.81 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $26.30 | $45.71 | $51.29 |
Where Iowa sits
The same service costs 3.0 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· 9th of 51
$589
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.