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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $537.03 Typical High $575.44 | Professional | None | $302.00 | $537.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $776.25 Typical High $776.25 | Facility | None | $436.52 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,047.13 | Professional | None | $707.95 | $1,000.00 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $912.01 | Professional | None | $676.08 | $741.31 | $912.01 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $3,630.78 | Facility | None | $467.74 | $758.58 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $616.60 Typical High $1,995.26 | Professional | None | $346.74 | $616.60 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | None | $812.83 | $1,047.13 | $1,047.13 |
Midlands Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | None | $794.33 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,122.02 Typical High $2,187.76 | Facility | None | $346.74 | $1,122.02 | $2,187.76 |
United Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $616.60 | Professional | None | $338.84 | $346.74 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $151.36 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $151.36 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $60.26 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $45.71 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $30.20 | $53.70 | $57.54 |
Where Iowa sits
The same service costs 2.8 times more in Montana 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· 9th of 51
$692
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.