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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $645.65 | Professional | None | $309.03 | $489.78 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $691.83 Typical High $691.83 | Facility | None | $389.05 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $933.25 | Professional | None | $645.65 | $912.01 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $812.83 | Professional | None | $602.56 | $616.60 | $812.83 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $691.83 Typical High $3,235.94 | Facility | None | $426.58 | $691.83 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $1,819.70 | Professional | None | $309.03 | $562.34 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | None | $724.44 | $933.25 | $933.25 |
Midlands Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,047.13 | Professional | None | $707.95 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,023.29 Typical High $1,949.84 | Facility | None | $331.13 | $1,023.29 | $1,949.84 |
United Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $549.54 | Professional | None | $309.03 | $316.23 | $549.54 |
Wellmark Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $154.88 Median $245.47 Typical High $323.59 | Professional | 52 · Reduced service | $154.88 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $97.72 Typical High $128.82 | Professional | 53 · Discontinued | $61.66 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $72.44 Typical High $97.72 | Professional | 55 · Aftercare only | $46.77 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $64.57 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $64.57 |
Where Iowa sits
The same service costs 2.6 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· 10th of 51
$617
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.