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 $691.83 Median $1,000.00 Typical High $1,445.44 | Professional | None | $691.83 | $1,000.00 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Facility | None | $912.01 | $1,445.44 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,862.09 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,513.56 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $1,412.54 Typical High $6,760.83 | Facility | None | $870.96 | $1,412.54 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $3,715.35 | Professional | None | $645.65 | $1,096.48 | $3,715.35 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,949.84 | $1,949.84 |
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 $1,479.11 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,479.11 | $2,137.96 | $2,137.96 |
United Setting Facility Modifier None Typical Low $676.08 Median $2,089.30 Typical High $4,073.80 | Facility | None | $676.08 | $2,089.30 | $4,073.80 |
United Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $1,148.15 | Professional | None | $630.96 | $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 $346.74 Median $501.19 Typical High $724.44 | Professional | 52 · Reduced service | $346.74 | $501.19 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $199.53 Typical High $288.40 | Professional | 53 · Discontinued | $138.04 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $151.36 Typical High $218.78 | Professional | 55 · Aftercare only | $102.33 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $144.54 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $144.54 |
Where Iowa sits
The same service costs 2.3 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
$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.