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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $676.08 Typical High $676.08 | Professional | None | $331.13 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $954.99 Typical High $954.99 | Facility | None | $660.69 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,348.96 | Professional | None | $891.25 | $1,148.15 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,000.00 | Professional | None | $758.58 | $933.25 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $3,981.07 | Facility | None | $588.84 | $933.25 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $741.31 Typical High $2,187.76 | Professional | None | $426.58 | $741.31 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,000.00 | $1,148.15 | $1,148.15 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $1,445.44 | Professional | None | $870.96 | $1,445.44 | $1,445.44 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,230.27 Typical High $2,398.83 | Facility | None | $549.54 | $1,230.27 | $2,398.83 |
United Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $758.58 | Professional | None | $398.11 | $436.52 | $758.58 |
Wellmark Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $165.96 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $66.07 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $50.12 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $33.11 | $67.61 | $67.61 |
Where Iowa sits
The same service costs 4.1 times more in Hawaii than in Kansas. 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· 9th of 51
$851
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.