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 $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,318.26 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $3,801.89 Typical High $3,801.89 | Facility | None | $1,778.28 | $3,801.89 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $4,265.80 Typical High $5,248.07 | Professional | None | $3,548.13 | $4,265.80 | $5,248.07 |
Hally Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $4,073.80 | Professional | None | $2,884.03 | $3,630.78 | $4,073.80 |
Medica Setting Facility Modifier None Typical Low $2,344.23 Median $3,715.35 Typical High $15,135.61 | Facility | None | $2,344.23 | $3,715.35 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $2,884.03 Typical High $8,317.64 | Professional | None | $1,698.24 | $2,884.03 | $8,317.64 |
Midlands Setting Professional Modifier None Typical Low $3,981.07 Median $4,265.80 Typical High $4,466.84 | Professional | None | $3,981.07 | $4,265.80 | $4,466.84 |
Midlands Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
Midlands Setting Professional Modifier None Typical Low $3,311.31 Median $5,754.40 Typical High $5,754.40 | Professional | None | $3,311.31 | $5,754.40 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $4,677.35 Typical High $8,912.51 | Facility | None | $1,862.09 | $4,677.35 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,584.89 | $1,698.24 | $3,019.95 |
Wellmark Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $645.65 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $645.65 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $263.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $194.98 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $131.83 | $263.03 | $263.03 |
Where Iowa sits
The same service costs 3.2 times more in Hawaii 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· 5th of 51
$3,388
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.