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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $147.91 Typical High $147.91 | Professional | None | $69.18 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $213.80 Typical High $213.80 | Facility | None | $100.00 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $251.19 | Professional | None | $186.21 | $239.88 | $251.19 |
Hally Health Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $239.88 | Professional | None | $158.49 | $190.55 | $239.88 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $208.93 Typical High $831.76 | Facility | None | $131.83 | $208.93 | $831.76 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $467.74 | Professional | None | $95.50 | $162.18 | $467.74 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $251.19 | Professional | None | $223.87 | $239.88 | $251.19 |
Midlands Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $323.59 | Professional | None | $181.97 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $107.15 Median $263.03 Typical High $501.19 | Facility | None | $107.15 | $263.03 | $501.19 |
United Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $169.82 | Professional | None | $89.13 | $95.50 | $169.82 |
Wellmark Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $34.67 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $34.67 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $13.80 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $10.47 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.92 | $14.79 | $14.79 |
Where Iowa sits
The same service costs 4.1 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· 3rd of 51
$191
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.