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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $2,398.83 | Professional | None | $1,288.25 | $2,344.23 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $3,388.44 | Facility | None | $2,041.74 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $4,168.69 Typical High $4,265.80 | Professional | None | $3,162.28 | $4,168.69 | $4,265.80 |
Hally Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $3,890.45 | Professional | None | $2,884.03 | $3,019.95 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $2,089.30 Median $3,311.31 Typical High $15,135.61 | Facility | None | $2,089.30 | $3,311.31 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $8,317.64 | Professional | None | $1,513.56 | $2,630.27 | $8,317.64 |
Midlands Setting Professional Modifier None Typical Low $3,548.13 Median $4,265.80 Typical High $4,265.80 | Professional | None | $3,548.13 | $4,265.80 | $4,265.80 |
Midlands Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $3,311.31 Median $5,128.61 Typical High $5,128.61 | Professional | None | $3,311.31 | $5,128.61 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,677.35 Typical High $8,912.51 | Facility | None | $1,949.84 | $4,677.35 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,548.82 | $2,691.53 |
Wellmark Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
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 $645.65 Median $1,174.90 Typical High $1,202.26 | Professional | 52 · Reduced service | $645.65 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $257.04 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $354.81 Typical High $363.08 | Professional | 55 · Aftercare only | $190.55 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $234.42 Typical High $239.88 | Professional | 56 · Pre-op care only | $128.82 | $234.42 | $239.88 |
Where Iowa sits
The same service costs 3.1 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· 7th of 51
$3,020
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.