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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $186.21 | Professional | None | $95.50 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $263.03 Typical High $263.03 | Facility | None | $138.04 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $338.84 | Professional | None | $245.47 | $331.13 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $288.40 | Professional | None | $223.87 | $234.42 | $288.40 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $1,174.90 | Facility | None | $162.18 | $263.03 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $645.65 | Professional | None | $117.49 | $204.17 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $331.13 | Professional | None | $275.42 | $331.13 | $331.13 |
Midlands Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $398.11 | Professional | None | $257.04 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $154.88 Median $363.08 Typical High $691.83 | Facility | None | $154.88 | $363.08 | $691.83 |
United Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $208.93 | Professional | None | $112.20 | $120.23 | $208.93 |
Wellmark Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $50.12 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $50.12 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $19.95 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $27.54 Typical High $28.18 | Professional | 55 · Aftercare only | $14.79 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.00 | $18.62 | $18.62 |
Where Iowa sits
The same service costs 3.5 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· 7th of 51
$234
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.