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 $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $426.58 | Professional | None | $234.42 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $616.60 Typical High $616.60 | Facility | None | $363.08 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $812.83 | Professional | None | $562.34 | $724.44 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,412.54 | Professional | None | $478.63 | $562.34 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $2,630.27 | Facility | None | $371.54 | $602.56 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $1,412.54 | Professional | None | $275.42 | $467.74 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | None | $645.65 | $724.44 | $724.44 |
Midlands Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $912.01 | Professional | None | $549.54 | $912.01 | $912.01 |
United Setting Facility Modifier None Typical Low $323.59 Median $794.33 Typical High $1,513.56 | Facility | None | $323.59 | $794.33 | $1,513.56 |
United Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $478.63 | Professional | None | $257.04 | $275.42 | $478.63 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $117.49 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $117.49 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $46.77 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $35.48 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $23.44 | $42.66 | $42.66 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in Alabama. 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· 6th of 51
$550
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.