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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $446.68 Typical High $446.68 | Professional | None | $229.09 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $630.96 Typical High $630.96 | Facility | None | $398.11 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $891.25 | Professional | None | $602.56 | $794.33 | $891.25 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $676.08 | Professional | None | $524.81 | $616.60 | $676.08 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $2,754.23 | Facility | None | $389.05 | $630.96 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $1,513.56 | Professional | None | $281.84 | $512.86 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $794.33 | Professional | None | $660.69 | $794.33 | $794.33 |
Midlands Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | None | $602.56 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $331.13 Median $870.96 Typical High $1,659.59 | Facility | None | $331.13 | $870.96 | $1,659.59 |
United Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $501.19 | Professional | None | $269.15 | $288.40 | $501.19 |
Wellmark Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $114.82 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $114.82 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $45.71 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $34.67 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $22.91 | $44.67 | $44.67 |
Where Iowa sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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
$562
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.