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 $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $776.25 Typical High $776.25 | Professional | None | $380.19 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,122.02 Typical High $1,122.02 | Facility | None | $645.65 | $1,122.02 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,122.02 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,023.29 | Professional | None | $776.25 | $954.99 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $4,073.80 | Facility | None | $676.08 | $1,096.48 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $851.14 Typical High $2,187.76 | Professional | None | $501.19 | $851.14 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,122.02 | $1,318.26 |
Midlands Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,659.59 Typical High $1,659.59 | Professional | None | $870.96 | $1,659.59 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,344.23 | Facility | None | $1,023.29 | $1,230.27 | $2,344.23 |
United Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $870.96 | Professional | None | $446.68 | $501.19 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $190.55 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $190.55 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $75.86 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $57.54 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $38.02 | $77.62 | $77.62 |
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· 3rd of 51
$1,000
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.