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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $537.03 Typical High $537.03 | Professional | None | $281.84 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $776.25 | Facility | None | $467.74 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,047.13 | Professional | None | $724.44 | $933.25 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $912.01 | Professional | None | $630.96 | $724.44 | $912.01 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $3,311.31 | Facility | None | $467.74 | $758.58 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $588.84 Typical High $1,819.70 | Professional | None | $346.74 | $588.84 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $933.25 | Professional | None | $812.83 | $933.25 | $933.25 |
Midlands Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | None | $724.44 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,023.29 Typical High $1,949.84 | Facility | None | $416.87 | $1,023.29 | $1,949.84 |
United Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $602.56 | Professional | None | $323.59 | $346.74 | $602.56 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $141.25 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $56.23 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $41.69 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $28.18 | $53.70 | $53.70 |
Where Iowa sits
The same service costs 2.9 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· 5th of 51
$692
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.