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 $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,951.21 Typical High $3,235.94 | Professional | None | $1,659.59 | $2,951.21 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $4,265.80 Typical High $4,265.80 | Facility | None | $2,454.71 | $4,265.80 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $5,128.61 Typical High $5,495.41 | Professional | None | $3,890.45 | $5,128.61 | $5,495.41 |
Hally Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,801.89 Typical High $4,466.84 | Professional | None | $3,630.78 | $3,801.89 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $2,570.40 Median $4,168.69 Typical High $17,782.79 | Facility | None | $2,570.40 | $4,168.69 | $17,782.79 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $3,235.94 Typical High $9,772.37 | Professional | None | $1,905.46 | $3,235.94 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $4,466.84 Median $5,128.61 Typical High $5,128.61 | Professional | None | $4,466.84 | $5,128.61 | $5,128.61 |
Midlands Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $3,890.45 Median $6,309.57 Typical High $6,309.57 | Professional | None | $3,890.45 | $6,309.57 | $6,309.57 |
United Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $10,715.19 | Facility | None | $5,495.41 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,778.28 | $1,905.46 | $3,311.31 |
Wellmark Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
2 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 55 · Aftercare only Typical Low $251.19 Median $446.68 Typical High $478.63 | Professional | 55 · Aftercare only | $251.19 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $295.12 Typical High $323.59 | Professional | 56 · Pre-op care only | $165.96 | $295.12 | $323.59 |
Where Iowa sits
The same service costs 2.3 times more in Montana 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· 3rd of 51
$3,802
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.