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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $380.19 | Professional | None | $181.97 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $549.54 Typical High $549.54 | Facility | None | $275.42 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $660.69 | Professional | None | $489.78 | $616.60 | $660.69 |
Hally Health Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $575.44 | Professional | None | $416.87 | $489.78 | $575.44 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $2,238.72 | Facility | None | $338.84 | $537.03 | $2,238.72 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $1,202.26 | Professional | None | $245.47 | $426.58 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $660.69 | Professional | None | $575.44 | $616.60 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $831.76 Typical High $831.76 | Professional | None | $478.63 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $275.42 Median $676.08 Typical High $1,288.25 | Facility | None | $275.42 | $676.08 | $1,288.25 |
United Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $436.52 | Professional | None | $229.09 | $245.47 | $436.52 |
Wellmark Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $91.20 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $91.20 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $36.31 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $26.92 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.20 | $38.02 | $38.02 |
Where Iowa sits
The same service costs 2.9 times more in Hawaii 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· 3rd of 51
$490
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.