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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,778.28 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $2,570.40 | Facility | None | $1,819.70 | $2,570.40 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,511.89 | $3,388.44 | $3,801.89 |
Hally Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $3,090.30 | Professional | None | $2,238.72 | $2,884.03 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $12,022.64 | Facility | None | $1,548.82 | $2,511.89 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,041.74 Typical High $6,606.93 | Professional | None | $1,148.15 | $2,041.74 | $6,606.93 |
Midlands Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,691.53 | $3,388.44 | $3,388.44 |
Midlands Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $2,630.27 Median $3,801.89 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,801.89 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,715.35 Typical High $7,244.36 | Facility | None | $1,148.15 | $3,715.35 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,148.15 | $2,041.74 |
Wellmark Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $602.56 Median $891.25 Typical High $1,202.26 | Professional | 52 · Reduced service | $602.56 | $891.25 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $354.81 Typical High $478.63 | Professional | 53 · Discontinued | $239.88 | $354.81 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $269.15 Typical High $363.08 | Professional | 55 · Aftercare only | $177.83 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $177.83 Typical High $239.88 | Professional | 56 · Pre-op care only | $120.23 | $177.83 | $239.88 |
Where Iowa sits
The same service costs 2.3 times more in Wisconsin than in Pennsylvania. 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· 11th of 51
$2,291
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.