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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $181.97 | Professional | None | $93.33 | $169.82 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $245.47 | Facility | None | $141.25 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $323.59 | Professional | None | $223.87 | $316.23 | $323.59 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $281.84 | Professional | None | $208.93 | $234.42 | $281.84 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $1,174.90 | Facility | None | $147.91 | $239.88 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $630.96 | Professional | None | $109.65 | $194.98 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $323.59 | Professional | None | $257.04 | $323.59 | $323.59 |
Midlands Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $363.08 | Professional | None | $251.19 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $158.49 Median $354.81 Typical High $691.83 | Facility | None | $158.49 | $354.81 | $691.83 |
United Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $194.98 | Professional | None | $107.15 | $109.65 | $194.98 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $47.86 Median $85.11 Typical High $91.20 | Professional | 52 · Reduced service | $47.86 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $33.88 Typical High $36.31 | Professional | 53 · Discontinued | $19.05 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $25.70 Typical High $27.54 | Professional | 55 · Aftercare only | $14.13 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $16.98 Typical High $18.20 | Professional | 56 · Pre-op care only | $9.55 | $16.98 | $18.20 |
Where Iowa sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 12th of 51
$219
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.