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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $181.97 | Professional | None | $100.00 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $263.03 | Facility | None | $125.89 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $346.74 | Professional | None | $239.88 | $288.40 | $346.74 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $275.42 | Professional | None | $190.55 | $234.42 | $275.42 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $1,047.13 | Facility | None | $158.49 | $257.04 | $1,047.13 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $562.34 | Professional | None | $117.49 | $199.53 | $562.34 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $309.03 | Professional | None | $275.42 | $288.40 | $309.03 |
Midlands Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $389.05 Typical High $389.05 | Professional | None | $218.78 | $389.05 | $389.05 |
United Setting Facility Modifier None Typical Low $120.23 Median $316.23 Typical High $602.56 | Facility | None | $120.23 | $316.23 | $602.56 |
United Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $204.17 | Professional | None | $109.65 | $117.49 | $204.17 |
Wellmark Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $50.12 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $50.12 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $19.95 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $15.14 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.00 | $18.20 | $18.20 |
Where Iowa sits
The same service costs 2.9 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· 2nd of 51
$234
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.