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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $331.13 | Professional | None | $173.78 | $316.23 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $446.68 Typical High $446.68 | Facility | None | $229.09 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $549.54 | Professional | None | $416.87 | $537.03 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $501.19 | Professional | None | $363.08 | $398.11 | $501.19 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $1,905.46 | Facility | None | $275.42 | $436.52 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $1,047.13 | Professional | None | $199.53 | $346.74 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | None | $467.74 | $549.54 | $549.54 |
Midlands Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $676.08 | Professional | None | $416.87 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $190.55 Median $602.56 Typical High $1,148.15 | Facility | None | $190.55 | $602.56 | $1,148.15 |
United Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $354.81 | Professional | None | $186.21 | $204.17 | $354.81 |
Wellmark Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $154.88 Typical High $165.96 | Professional | 52 · Reduced service | $89.13 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $63.10 Typical High $66.07 | Professional | 53 · Discontinued | $35.48 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $26.92 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $31.62 Typical High $33.11 | Professional | 56 · Pre-op care only | $17.78 | $31.62 | $33.11 |
Where Iowa sits
The same service costs 2.7 times more in Montana 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· 5th of 51
$398
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.