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 $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $741.31 | Professional | None | $380.19 | $724.44 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,023.29 | Facility | None | $616.60 | $1,023.29 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,380.38 | Professional | None | $954.99 | $1,318.26 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,148.15 | Professional | None | $870.96 | $954.99 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,023.29 Typical High $4,677.35 | Facility | None | $630.96 | $1,023.29 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $794.33 Typical High $2,511.89 | Professional | None | $457.09 | $794.33 | $2,511.89 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,318.26 | $1,318.26 |
Midlands Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,548.82 | $1,548.82 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,412.54 Typical High $2,754.23 | Facility | None | $707.95 | $1,412.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $812.83 | Professional | None | $436.52 | $467.74 | $812.83 |
Wellmark Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $190.55 Median $354.81 Typical High $371.54 | Professional | 52 · Reduced service | $190.55 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $75.86 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $107.15 Typical High $109.65 | Professional | 55 · Aftercare only | $57.54 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $38.02 | $72.44 | $74.13 |
Where Iowa sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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
$912
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.