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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $407.38 Typical High $407.38 | Professional | None | $190.55 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $588.84 | Facility | None | $363.08 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $794.33 | Professional | None | $537.03 | $645.65 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $616.60 | Professional | None | $436.52 | $524.81 | $616.60 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $575.44 Typical High $2,344.23 | Facility | None | $363.08 | $575.44 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $1,258.93 | Professional | None | $263.03 | $446.68 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $691.83 | Professional | None | $616.60 | $645.65 | $691.83 |
Midlands Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $870.96 | Professional | None | $501.19 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,380.38 | Facility | None | $223.87 | $707.95 | $1,380.38 |
United Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $467.74 | Professional | None | $245.47 | $263.03 | $467.74 |
Wellmark Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $95.50 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $95.50 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $38.02 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $28.84 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $19.05 | $40.74 | $40.74 |
Where Iowa sits
The same service costs 2.2 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· 3rd of 51
$525
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.