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 $269.15 Median $457.09 Typical High $489.78 | Professional | None | $269.15 | $457.09 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $660.69 Typical High $660.69 | Facility | None | $380.19 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $870.96 | Professional | None | $602.56 | $851.14 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $758.58 | Professional | None | $562.34 | $630.96 | $758.58 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $645.65 Typical High $3,162.28 | Facility | None | $398.11 | $645.65 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $1,698.24 | Professional | None | $295.12 | $524.81 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | None | $691.83 | $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 $1,862.09 | Facility | None | $389.05 | $954.99 | $1,862.09 |
United Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $524.81 | Professional | None | $288.40 | $295.12 | $524.81 |
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 $144.54 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $144.54 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $57.54 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $69.18 Typical High $74.13 | Professional | 55 · Aftercare only | $42.66 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $28.84 | $45.71 | $48.98 |
Where Iowa sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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.