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 $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,548.82 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $4,466.84 Typical High $4,466.84 | Facility | None | $2,137.96 | $4,466.84 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $4,168.69 Median $5,128.61 Typical High $6,025.60 | Professional | None | $4,168.69 | $5,128.61 | $6,025.60 |
Hally Health Setting Professional Modifier None Typical Low $3,630.78 Median $4,073.80 Typical High $4,677.35 | Professional | None | $3,630.78 | $4,073.80 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $2,754.23 Median $4,365.16 Typical High $18,197.01 | Facility | None | $2,754.23 | $4,365.16 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,995.26 Median $3,467.37 Typical High $10,000.00 | Professional | None | $1,995.26 | $3,467.37 | $10,000.00 |
Midlands Setting Professional Modifier None Typical Low $4,677.35 Median $5,128.61 Typical High $5,370.32 | Professional | None | $4,677.35 | $5,128.61 | $5,370.32 |
Midlands Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Midlands Setting Professional Modifier None Typical Low $3,981.07 Median $6,760.83 Typical High $6,760.83 | Professional | None | $3,981.07 | $6,760.83 | $6,760.83 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $5,623.41 Typical High $10,964.78 | Facility | None | $4,677.35 | $5,623.41 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,862.09 | $1,995.26 | $3,548.13 |
Wellmark Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $794.33 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $794.33 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $316.23 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $234.42 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $158.49 | $316.23 | $316.23 |
Where Iowa sits
The same service costs 2.6 times more in Wisconsin 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· 3rd of 51
$3,981
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.