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 $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $5,370.32 Typical High $5,370.32 | Professional | None | $2,238.72 | $5,370.32 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $7,762.47 Typical High $7,762.47 | Facility | None | $3,715.35 | $7,762.47 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $6,760.83 Median $7,762.47 Typical High $9,120.11 | Professional | None | $6,760.83 | $7,762.47 | $9,120.11 |
Hally Health Setting Professional Modifier None Typical Low $5,248.07 Median $6,760.83 Typical High $8,128.31 | Professional | None | $5,248.07 | $6,760.83 | $8,128.31 |
Medica Setting Facility Modifier None Typical Low $4,786.30 Median $7,585.78 Typical High $27,542.29 | Facility | None | $4,786.30 | $7,585.78 | $27,542.29 |
Medica Setting Professional Modifier None Typical Low $3,467.37 Median $5,888.44 Typical High $15,135.61 | Professional | None | $3,467.37 | $5,888.44 | $15,135.61 |
Midlands Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $9,120.11 | Professional | None | $7,762.47 | $7,762.47 | $9,120.11 |
Midlands Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $6,025.60 Median $11,481.54 Typical High $11,481.54 | Professional | None | $6,025.60 | $11,481.54 | $11,481.54 |
United Setting Facility Modifier None Typical Low $7,079.46 Median $8,511.38 Typical High $16,218.10 | Facility | None | $7,079.46 | $8,511.38 | $16,218.10 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $3,467.37 Typical High $6,165.95 | Professional | None | $3,019.95 | $3,467.37 | $6,165.95 |
Wellmark Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
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 $1,148.15 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,148.15 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $457.09 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $338.84 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $229.09 | $537.03 | $537.03 |
Where Iowa sits
The same service costs 2.9 times more in Hawaii than in Pennsylvania. 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· 4th of 51
$6,918
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.