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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $331.13 | Professional | None | $173.78 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $478.63 | Facility | None | $309.03 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $691.83 | Professional | None | $457.09 | $588.84 | $691.83 |
Hally Health Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $512.86 | Professional | None | $398.11 | $478.63 | $512.86 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $467.74 Typical High $2,089.30 | Facility | None | $288.40 | $467.74 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $1,148.15 | Professional | None | $213.80 | $363.08 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | None | $501.19 | $588.84 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $707.95 | Professional | None | $457.09 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $245.47 Median $645.65 Typical High $1,258.93 | Facility | None | $245.47 | $645.65 | $1,258.93 |
United Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $371.54 | Professional | None | $204.17 | $213.80 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $89.13 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $89.13 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $66.07 Typical High $67.61 | Professional | 53 · Discontinued | $35.48 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $26.92 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $17.78 | $33.11 | $33.11 |
Where Iowa sits
The same service costs 2.5 times more in Hawaii 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· 5th of 51
$427
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.