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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $416.87 Typical High $446.68 | Professional | None | $213.80 | $416.87 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $602.56 Typical High $602.56 | Facility | None | $263.03 | $602.56 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $707.95 | Professional | None | $467.74 | $602.56 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $630.96 | Professional | None | $407.38 | $537.03 | $630.96 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $2,290.87 | Facility | None | $363.08 | $588.84 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $1,174.90 | Professional | None | $269.15 | $457.09 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | None | $602.56 | $602.56 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $891.25 Typical High $891.25 | Professional | None | $467.74 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $549.54 Median $660.69 Typical High $1,258.93 | Facility | None | $549.54 | $660.69 | $1,258.93 |
United Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $467.74 | Professional | None | $234.42 | $269.15 | $467.74 |
Wellmark Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $107.15 Median $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $107.15 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $83.18 Typical High $91.20 | Professional | 53 · Discontinued | $42.66 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $63.10 Typical High $67.61 | Professional | 55 · Aftercare only | $32.36 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $21.38 | $41.69 | $44.67 |
Where Iowa sits
The same service costs 3.0 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· 4th of 51
$537
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.