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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $467.74 | Professional | None | $245.47 | $436.52 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $630.96 Typical High $630.96 | Facility | None | $363.08 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $812.83 | Professional | None | $575.44 | $741.31 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $660.69 | Professional | None | $537.03 | $562.34 | $660.69 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $2,630.27 | Facility | None | $380.19 | $616.60 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $1,445.44 | Professional | None | $275.42 | $478.63 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | None | $645.65 | $741.31 | $741.31 |
Midlands Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $933.25 | Professional | None | $575.44 | $933.25 | $933.25 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $1,584.89 | Facility | None | $812.83 | $812.83 | $1,584.89 |
United Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $489.78 | Professional | None | $263.03 | $281.84 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $123.03 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $123.03 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $48.98 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $36.31 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $24.55 | $43.65 | $46.77 |
Where Iowa sits
The same service costs 2.2 times more in Montana 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
$562
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.