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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,479.11 Typical High $1,548.82 | Professional | None | $831.76 | $1,479.11 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $2,137.96 | Facility | None | $1,412.54 | $2,137.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,754.23 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,819.70 | $1,995.26 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $10,000.00 | Facility | None | $1,318.26 | $2,089.30 | $10,000.00 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,698.24 Typical High $5,370.32 | Professional | None | $954.99 | $1,698.24 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,754.23 | $2,754.23 |
Midlands Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,089.30 | $3,162.28 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,019.95 Typical High $5,754.40 | Facility | None | $1,318.26 | $3,019.95 | $5,754.40 |
United Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,698.24 | Professional | None | $912.01 | $954.99 | $1,698.24 |
Wellmark Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $416.87 Median $741.31 Typical High $776.25 | Professional | 52 · Reduced service | $416.87 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $295.12 Typical High $309.03 | Professional | 53 · Discontinued | $165.96 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $125.89 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $147.91 Typical High $154.88 | Professional | 56 · Pre-op care only | $83.18 | $147.91 | $154.88 |
Where Iowa sits
The same service costs 3.6 times more in Hawaii than in Washington, DC. 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
$1,905
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.