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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $213.80 | Professional | None | $97.72 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $302.00 | Facility | None | $169.82 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $363.08 | Professional | None | $281.84 | $302.00 | $363.08 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $346.74 | Professional | None | $204.17 | $269.15 | $346.74 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $302.00 Typical High $1,148.15 | Facility | None | $186.21 | $302.00 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $588.84 | Professional | None | $134.90 | $234.42 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | None | $302.00 | $302.00 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $457.09 Typical High $457.09 | Professional | None | $234.42 | $457.09 | $457.09 |
United Setting Facility Modifier None Typical Low $134.90 Median $331.13 Typical High $645.65 | Facility | None | $134.90 | $331.13 | $645.65 |
United Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $239.88 | Professional | None | $120.23 | $134.90 | $239.88 |
Wellmark Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $50.12 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $50.12 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $19.95 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $15.14 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $10.00 | $21.38 | $21.38 |
Where Iowa sits
The same service costs 2.7 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· 2nd of 51
$269
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.