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 $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $575.44 | Professional | None | $295.12 | $524.81 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $758.58 | Facility | None | $524.81 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,122.02 | Professional | None | $724.44 | $954.99 | $1,122.02 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $891.25 | Professional | None | $645.65 | $758.58 | $891.25 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $3,388.44 | Facility | None | $457.09 | $741.31 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $1,862.09 | Professional | None | $331.13 | $575.44 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $954.99 | Professional | None | $776.25 | $954.99 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,122.02 | Professional | None | $724.44 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $380.19 Median $1,047.13 Typical High $1,995.26 | Facility | None | $380.19 | $1,047.13 | $1,995.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $588.84 | Professional | None | $316.23 | $338.84 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $147.91 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $147.91 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $60.26 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $77.62 Typical High $87.10 | Professional | 55 · Aftercare only | $44.67 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $29.51 | $52.48 | $57.54 |
Where Iowa sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 8th of 51
$676
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.