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 $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $575.44 Typical High $575.44 | Professional | None | $281.84 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $831.76 Typical High $831.76 | Facility | None | $398.11 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,096.48 | Professional | None | $776.25 | $954.99 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $870.96 | Professional | None | $645.65 | $758.58 | $870.96 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $812.83 Typical High $3,311.31 | Facility | None | $512.86 | $812.83 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $1,819.70 | Professional | None | $371.54 | $645.65 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,000.00 | Professional | None | $870.96 | $954.99 | $1,000.00 |
Midlands Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $1,258.93 Typical High $1,258.93 | Professional | None | $724.44 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,995.26 | Facility | None | $851.14 | $1,023.29 | $1,995.26 |
United Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $660.69 | Professional | None | $346.74 | $371.54 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $141.25 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $141.25 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $56.23 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $42.66 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $28.18 | $57.54 | $57.54 |
Where Iowa sits
The same service costs 2.8 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· 4th of 51
$741
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.