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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,000.00 | Professional | None | $501.19 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $1,445.44 | Facility | None | $870.96 | $1,445.44 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,621.81 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,318.26 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $5,623.41 | Facility | None | $891.25 | $1,412.54 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $3,162.28 | Professional | None | $645.65 | $1,122.02 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,513.56 | $1,621.81 | $1,698.24 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,230.27 | $2,187.76 | $2,187.76 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,388.44 | Facility | None | $645.65 | $1,778.28 | $3,388.44 |
United Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $1,148.15 | Professional | None | $602.56 | $645.65 | $1,148.15 |
Wellmark Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $251.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $251.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $100.00 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $75.86 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $50.12 | $100.00 | $100.00 |
Where Iowa sits
The same service costs 2.3 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
$1,288
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.