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 $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $741.31 Typical High $741.31 | Professional | None | $316.23 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $1,047.13 | Facility | None | $446.68 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,258.93 | Professional | None | $812.83 | $1,047.13 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,096.48 | Professional | None | $707.95 | $891.25 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,023.29 Typical High $3,715.35 | Facility | None | $645.65 | $1,023.29 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $2,041.74 | Professional | None | $467.74 | $812.83 | $2,041.74 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | None | $1,047.13 | $1,047.13 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $1,584.89 Typical High $1,584.89 | Professional | None | $812.83 | $1,584.89 | $1,584.89 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,238.72 | Facility | None | $954.99 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $831.76 | Professional | None | $407.38 | $467.74 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $165.96 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $165.96 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $66.07 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $48.98 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $33.11 | $74.13 | $74.13 |
Where Iowa sits
The same service costs 2.8 times more in Iowa 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· 1st of 51
$933
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.