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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $186.21 | Professional | None | $95.50 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $269.15 Typical High $269.15 | Facility | None | $165.96 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $363.08 | Professional | None | $245.47 | $316.23 | $363.08 |
Hally Health Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $288.40 | Professional | None | $213.80 | $251.19 | $288.40 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $1,122.02 | Facility | None | $162.18 | $263.03 | $1,122.02 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $616.60 | Professional | None | $117.49 | $204.17 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | None | $275.42 | $316.23 | $316.23 |
Midlands Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $398.11 | Professional | None | $239.88 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $141.25 Median $346.74 Typical High $660.69 | Facility | None | $141.25 | $346.74 | $660.69 |
United Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $208.93 | Professional | None | $112.20 | $120.23 | $208.93 |
Wellmark Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $47.86 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $47.86 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $19.05 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $14.13 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.55 | $18.62 | $18.62 |
Where Iowa sits
The same service costs 2.8 times more in Hawaii than in Florida. 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
$240
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.