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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $234.42 | Professional | None | $128.82 | $223.87 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $323.59 Typical High $323.59 | Facility | None | $177.83 | $323.59 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $478.63 | Professional | None | $316.23 | $416.87 | $478.63 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $398.11 | Professional | None | $275.42 | $338.84 | $398.11 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $1,513.56 | Facility | None | $199.53 | $316.23 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $812.83 | Professional | None | $144.54 | $245.47 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $416.87 | Professional | None | $338.84 | $416.87 | $416.87 |
Midlands Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | None | $316.23 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $208.93 Median $457.09 Typical High $870.96 | Facility | None | $208.93 | $457.09 | $870.96 |
United Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $257.04 | Professional | None | $138.04 | $144.54 | $257.04 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $64.57 Median $112.20 Typical High $117.49 | Professional | 52 · Reduced service | $64.57 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $44.67 Typical High $46.77 | Professional | 53 · Discontinued | $25.70 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $33.88 Typical High $35.48 | Professional | 55 · Aftercare only | $19.50 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $22.39 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.88 | $22.39 | $23.44 |
Where Iowa sits
The same service costs 3.5 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· 11th of 51
$288
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.