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 $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $7,943.28 Typical High $9,120.11 | Professional | None | $4,570.88 | $7,943.28 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $11,220.18 Typical High $11,220.18 | Facility | None | $7,585.78 | $11,220.18 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $10,471.29 Median $14,125.38 Typical High $15,488.17 | Professional | None | $10,471.29 | $14,125.38 | $15,488.17 |
Hally Health Setting Professional Modifier None Typical Low $9,772.37 Median $10,715.19 Typical High $13,182.57 | Professional | None | $9,772.37 | $10,715.19 | $13,182.57 |
Medica Setting Facility Modifier None Typical Low $6,918.31 Median $11,220.18 Typical High $48,977.88 | Facility | None | $6,918.31 | $11,220.18 | $48,977.88 |
Medica Setting Professional Modifier None Typical Low $5,011.87 Median $8,709.64 Typical High $27,542.29 | Professional | None | $5,011.87 | $8,709.64 | $27,542.29 |
Midlands Setting Professional Modifier None Typical Low $11,748.98 Median $14,125.38 Typical High $14,125.38 | Professional | None | $11,748.98 | $14,125.38 | $14,125.38 |
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 $16,982.44 Typical High $16,982.44 | Professional | None | $10,715.19 | $16,982.44 | $16,982.44 |
United Setting Facility Modifier None Typical Low $4,786.30 Median $15,488.17 Typical High $29,512.09 | Facility | None | $4,786.30 | $15,488.17 | $29,512.09 |
United Setting Professional Modifier None Typical Low $4,786.30 Median $5,128.61 Typical High $8,912.51 | Professional | None | $4,786.30 | $5,128.61 | $8,912.51 |
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 $3,981.07 Typical High $4,570.88 | Professional | 52 · Reduced service | $2,290.87 | $3,981.07 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,584.89 Typical High $1,819.70 | Professional | 53 · Discontinued | $933.25 | $1,584.89 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $1,174.90 Typical High $1,380.38 | Professional | 55 · Aftercare only | $691.83 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $794.33 Typical High $912.01 | Professional | 56 · Pre-op care only | $457.09 | $794.33 | $912.01 |
Where Iowa sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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
$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.