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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,348.96 Typical High $1,513.56 | Professional | None | $758.58 | $1,348.96 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,318.26 | $1,905.46 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,862.09 | $2,454.71 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,995.26 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $8,511.38 | Facility | None | $1,174.90 | $1,905.46 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,513.56 Typical High $4,786.30 | Professional | None | $851.14 | $1,513.56 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,995.26 | $2,454.71 | $2,454.71 |
Midlands Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $2,884.03 | Professional | None | $1,905.46 | $2,884.03 | $2,884.03 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,691.53 Typical High $5,248.07 | Facility | None | $831.76 | $2,691.53 | $5,248.07 |
United Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,513.56 | Professional | None | $831.76 | $870.96 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $389.05 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $389.05 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $269.15 Typical High $302.00 | Professional | 53 · Discontinued | $158.49 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $117.49 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $77.62 | $134.90 | $151.36 |
Where Iowa sits
The same service costs 2.5 times more in Montana 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· 8th of 51
$1,698
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.