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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $363.08 Typical High $363.08 | Professional | None | $151.36 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $524.81 Typical High $524.81 | Facility | None | $245.47 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $616.60 | Professional | None | $436.52 | $524.81 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $549.54 | Professional | None | $346.74 | $467.74 | $549.54 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $512.86 Typical High $1,862.09 | Facility | None | $316.23 | $512.86 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $1,023.29 | Professional | None | $234.42 | $398.11 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | None | $524.81 | $524.81 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $776.25 Typical High $776.25 | Professional | None | $398.11 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $281.84 Median $575.44 Typical High $1,096.48 | Facility | None | $281.84 | $575.44 | $1,096.48 |
United Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $407.38 | Professional | None | $204.17 | $234.42 | $407.38 |
Wellmark Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $75.86 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $75.86 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $30.20 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $22.91 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $15.14 | $36.31 | $36.31 |
Where Iowa sits
The same service costs 3.6 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· 3rd of 51
$468
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.