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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $616.60 | Professional | None | $302.00 | $501.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $724.44 | Facility | None | $416.87 | $724.44 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $954.99 | Professional | None | $707.95 | $933.25 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,202.26 | Professional | None | $616.60 | $724.44 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $3,388.44 | Facility | None | $436.52 | $707.95 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $602.56 Typical High $1,862.09 | Professional | None | $316.23 | $602.56 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $954.99 | Professional | None | $741.31 | $954.99 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | None | $724.44 | $1,071.52 | $1,071.52 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,047.13 Typical High $1,995.26 | Facility | None | $467.74 | $1,047.13 | $1,995.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $562.34 | Professional | None | $316.23 | $323.59 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
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 $151.36 Median $251.19 Typical High $309.03 | Professional | 52 · Reduced service | $151.36 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $100.00 Typical High $123.03 | Professional | 53 · Discontinued | $60.26 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $74.13 Typical High $91.20 | Professional | 55 · Aftercare only | $45.71 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $50.12 Typical High $61.66 | Professional | 56 · Pre-op care only | $30.20 | $50.12 | $61.66 |
Where Iowa sits
The same service costs 3.9 times more in Hawaii than in Delaware. 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
$631
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.