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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $380.19 | Professional | None | $194.98 | $363.08 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $524.81 Typical High $524.81 | Facility | None | $316.23 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $707.95 | Professional | None | $478.63 | $660.69 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $616.60 | Professional | None | $446.68 | $489.78 | $616.60 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $512.86 Typical High $2,290.87 | Facility | None | $316.23 | $512.86 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $1,288.25 | Professional | None | $234.42 | $416.87 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $660.69 | Professional | None | $549.54 | $660.69 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $776.25 | Professional | None | $501.19 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $257.04 Median $724.44 Typical High $1,380.38 | Facility | None | $257.04 | $724.44 | $1,380.38 |
United Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $407.38 | Professional | None | $223.87 | $234.42 | $407.38 |
Wellmark Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $97.72 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $97.72 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $38.90 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $54.95 Typical High $56.23 | Professional | 55 · Aftercare only | $29.51 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.50 | $36.31 | $38.02 |
Where Iowa sits
The same service costs 2.5 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· 5th of 51
$468
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.