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 $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $3,801.89 Typical High $3,890.45 | Professional | None | $2,041.74 | $3,801.89 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $5,495.41 Typical High $5,495.41 | Facility | None | $3,548.13 | $5,495.41 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $6,918.31 Typical High $7,943.28 | Professional | None | $5,248.07 | $6,918.31 | $7,943.28 |
Hally Health Setting Professional Modifier None Typical Low $4,677.35 Median $5,495.41 Typical High $6,918.31 | Professional | None | $4,677.35 | $5,495.41 | $6,918.31 |
Medica Setting Facility Modifier None Typical Low $3,388.44 Median $5,370.32 Typical High $23,988.33 | Facility | None | $3,388.44 | $5,370.32 | $23,988.33 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $4,168.69 Typical High $13,182.57 | Professional | None | $2,454.71 | $4,168.69 | $13,182.57 |
Midlands Setting Professional Modifier None Typical Low $5,754.40 Median $6,918.31 Typical High $6,918.31 | Professional | None | $5,754.40 | $6,918.31 | $6,918.31 |
Midlands Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
Midlands Setting Professional Modifier None Typical Low $5,248.07 Median $8,317.64 Typical High $8,317.64 | Professional | None | $5,248.07 | $8,317.64 | $8,317.64 |
United Setting Facility Modifier None Typical Low $3,890.45 Median $7,413.10 Typical High $14,454.40 | Facility | None | $3,890.45 | $7,413.10 | $14,454.40 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $4,365.16 | Professional | None | $2,290.87 | $2,454.71 | $4,365.16 |
Wellmark Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
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 $1,023.29 Median $1,905.46 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,023.29 | $1,905.46 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $776.25 Typical High $794.33 | Professional | 53 · Discontinued | $407.38 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $575.44 Typical High $588.84 | Professional | 55 · Aftercare only | $302.00 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $380.19 Typical High $389.05 | Professional | 56 · Pre-op care only | $204.17 | $380.19 | $389.05 |
Where Iowa sits
The same service costs 3.0 times more in Hawaii than in Pennsylvania. 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
$4,898
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.