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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $758.58 | Professional | None | $389.05 | $676.08 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $977.24 | Facility | None | $691.83 | $977.24 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,479.11 | Professional | None | $954.99 | $1,230.27 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,819.70 | Professional | None | $851.14 | $1,071.52 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $4,466.84 | Facility | None | $602.56 | $954.99 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $758.58 Typical High $2,398.83 | Professional | None | $436.52 | $758.58 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,230.27 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $1,479.11 | Professional | None | $954.99 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,348.96 Typical High $2,570.40 | Facility | None | $501.19 | $1,348.96 | $2,570.40 |
United Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $776.25 | Professional | None | $407.38 | $436.52 | $776.25 |
Wellmark Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $194.98 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $194.98 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $77.62 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $58.88 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $38.90 | $67.61 | $75.86 |
Where Iowa sits
The same service costs 2.4 times more in Hawaii than in Washington, DC. 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
$871
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.