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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $436.52 | Professional | None | $229.09 | $407.38 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $588.84 | Facility | None | $363.08 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $776.25 | Professional | None | $537.03 | $741.31 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $776.25 | Professional | None | $501.19 | $524.81 | $776.25 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $575.44 Typical High $2,754.23 | Facility | None | $354.81 | $575.44 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $1,513.56 | Professional | None | $263.03 | $446.68 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | None | $616.60 | $776.25 | $776.25 |
Midlands Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | None | $588.84 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $416.87 Median $851.14 Typical High $1,621.81 | Facility | None | $416.87 | $851.14 | $1,621.81 |
United Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $457.09 | Professional | None | $257.04 | $263.03 | $457.09 |
Wellmark Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $114.82 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $114.82 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $46.77 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $34.67 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $22.91 | $40.74 | $43.65 |
Where Iowa sits
The same service costs 3.7 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· 8th of 51
$525
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.