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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $380.19 Typical High $380.19 | Professional | None | $194.98 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $549.54 Typical High $549.54 | Facility | None | $281.84 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $645.65 | Professional | None | $501.19 | $645.65 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $602.56 | Professional | None | $436.52 | $489.78 | $602.56 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $2,344.23 | Facility | None | $331.13 | $537.03 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $1,258.93 | Professional | None | $245.47 | $416.87 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | None | $575.44 | $645.65 | $645.65 |
Midlands Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $812.83 | Professional | None | $501.19 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $389.05 Median $707.95 Typical High $1,348.96 | Facility | None | $389.05 | $707.95 | $1,348.96 |
United Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $426.58 | Professional | None | $223.87 | $245.47 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $97.72 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $97.72 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $38.90 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $28.84 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.50 | $38.02 | $38.02 |
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· 6th of 51
$490
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.