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 $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $275.42 | Professional | None | $141.25 | $251.19 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $363.08 | Facility | None | $204.17 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $489.78 | Professional | None | $338.84 | $467.74 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $426.58 | Professional | None | $316.23 | $346.74 | $426.58 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $354.81 Typical High $1,698.24 | Facility | None | $223.87 | $354.81 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $954.99 | Professional | None | $162.18 | $295.12 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $489.78 | Professional | None | $380.19 | $489.78 | $489.78 |
Midlands Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $549.54 | Professional | None | $371.54 | $549.54 | $549.54 |
United Setting Facility Modifier None Typical Low $218.78 Median $537.03 Typical High $1,023.29 | Facility | None | $218.78 | $537.03 | $1,023.29 |
United Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $288.40 | Professional | None | $162.18 | $165.96 | $288.40 |
Wellmark Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $72.44 Median $125.89 Typical High $138.04 | Professional | 52 · Reduced service | $72.44 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $51.29 Typical High $54.95 | Professional | 53 · Discontinued | $28.84 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $38.02 Typical High $40.74 | Professional | 55 · Aftercare only | $21.88 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $25.12 Typical High $27.54 | Professional | 56 · Pre-op care only | $14.45 | $25.12 | $27.54 |
Where Iowa sits
The same service costs 3.3 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
$324
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.