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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $501.19 | Professional | None | $257.04 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $707.95 | Facility | None | $398.11 | $707.95 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $954.99 | Professional | None | $660.69 | $891.25 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $776.25 | Professional | None | $588.84 | $660.69 | $776.25 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $3,162.28 | Facility | None | $436.52 | $707.95 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $1,698.24 | Professional | None | $316.23 | $549.54 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | None | $741.31 | $891.25 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | None | $676.08 | $1,071.52 | $1,071.52 |
United Setting Facility Modifier None Typical Low $398.11 Median $954.99 Typical High $1,862.09 | Facility | None | $398.11 | $954.99 | $1,862.09 |
United Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $562.34 | Professional | None | $302.00 | $323.59 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
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 $128.82 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $128.82 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $51.29 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $38.90 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $25.70 | $50.12 | $50.12 |
Where Iowa sits
The same service costs 3.7 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· 6th of 51
$631
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.