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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $186.21 | Professional | None | $109.65 | $173.78 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $251.19 Typical High $251.19 | Facility | None | $181.97 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $371.54 | Professional | None | $245.47 | $331.13 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $323.59 | Professional | None | $213.80 | $269.15 | $323.59 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $1,174.90 | Facility | None | $151.36 | $245.47 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $645.65 | Professional | None | $109.65 | $194.98 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $331.13 | Professional | None | $263.03 | $331.13 | $331.13 |
Midlands Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $371.54 | Professional | None | $257.04 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $173.78 Median $363.08 Typical High $691.83 | Facility | None | $173.78 | $363.08 | $691.83 |
United Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $194.98 | Professional | None | $109.65 | $112.20 | $194.98 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $54.95 Median $87.10 Typical High $93.33 | Professional | 52 · Reduced service | $54.95 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $37.15 | Professional | 53 · Discontinued | $21.88 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.30 Typical High $28.18 | Professional | 55 · Aftercare only | $16.22 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.38 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.96 | $17.38 | $18.62 |
Where Iowa sits
The same service costs 3.5 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· 7th of 51
$224
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.