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 $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $7,762.47 Typical High $9,120.11 | Professional | None | $4,466.84 | $7,762.47 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $11,220.18 Typical High $11,220.18 | Facility | None | $7,244.36 | $11,220.18 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $10,471.29 Median $13,803.84 Typical High $15,488.17 | Professional | None | $10,471.29 | $13,803.84 | $15,488.17 |
Hally Health Setting Professional Modifier None Typical Low $9,120.11 Median $10,471.29 Typical High $11,481.54 | Professional | None | $9,120.11 | $10,471.29 | $11,481.54 |
Medica Setting Facility Modifier None Typical Low $6,760.83 Median $10,964.78 Typical High $47,863.01 | Facility | None | $6,760.83 | $10,964.78 | $47,863.01 |
Medica Setting Professional Modifier None Typical Low $4,897.79 Median $8,912.51 Typical High $26,915.35 | Professional | None | $4,897.79 | $8,912.51 | $26,915.35 |
Midlands Setting Professional Modifier None Typical Low $11,481.54 Median $13,803.84 Typical High $13,803.84 | Professional | None | $11,481.54 | $13,803.84 | $13,803.84 |
Midlands Setting Facility Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Facility | None | $11,220.18 | $11,220.18 | $11,220.18 |
Midlands Setting Professional Modifier None Typical Low $10,715.19 Median $16,595.87 Typical High $16,595.87 | Professional | None | $10,715.19 | $16,595.87 | $16,595.87 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $15,135.61 Typical High $28,840.32 | Facility | None | $5,128.61 | $15,135.61 | $28,840.32 |
United Setting Professional Modifier None Typical Low $4,677.35 Median $5,011.87 Typical High $8,709.64 | Professional | None | $4,677.35 | $5,011.87 | $8,709.64 |
Wellmark Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
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 $2,290.87 Median $3,890.45 Typical High $4,570.88 | Professional | 52 · Reduced service | $2,290.87 | $3,890.45 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $1,548.82 Typical High $1,819.70 | Professional | 53 · Discontinued | $912.01 | $1,548.82 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $1,148.15 Typical High $1,348.96 | Professional | 55 · Aftercare only | $676.08 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $776.25 Typical High $912.01 | Professional | 56 · Pre-op care only | $457.09 | $776.25 | $912.01 |
Where Iowa sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 9th of 51
$10,000
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.