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 $9,549.93 Median $9,549.93 Typical High $9,549.93 | Facility | None | $9,549.93 | $9,549.93 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $5,623.41 Median $9,549.93 Typical High $10,715.19 | Professional | None | $5,623.41 | $9,549.93 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $13,803.84 Typical High $13,803.84 | Facility | None | $9,120.11 | $13,803.84 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $13,489.63 Median $18,197.01 Typical High $20,417.38 | Professional | None | $13,489.63 | $18,197.01 | $20,417.38 |
Hally Health Setting Professional Modifier None Typical Low $11,748.98 Median $14,125.38 Typical High $15,488.17 | Professional | None | $11,748.98 | $14,125.38 | $15,488.17 |
Medica Setting Facility Modifier None Typical Low $8,317.64 Median $13,489.63 Typical High $63,095.73 | Facility | None | $8,317.64 | $13,489.63 | $63,095.73 |
Medica Setting Professional Modifier None Typical Low $6,165.95 Median $10,964.78 Typical High $35,481.34 | Professional | None | $6,165.95 | $10,964.78 | $35,481.34 |
Midlands Setting Professional Modifier None Typical Low $14,454.40 Median $18,197.01 Typical High $18,197.01 | Professional | None | $14,454.40 | $18,197.01 | $18,197.01 |
Midlands Setting Facility Modifier None Typical Low $13,803.84 Median $13,803.84 Typical High $13,803.84 | Facility | None | $13,803.84 | $13,803.84 | $13,803.84 |
Midlands Setting Professional Modifier None Typical Low $14,125.38 Median $20,417.38 Typical High $20,417.38 | Professional | None | $14,125.38 | $20,417.38 | $20,417.38 |
United Setting Facility Modifier None Typical Low $6,165.95 Median $19,952.62 Typical High $38,904.51 | Facility | None | $6,165.95 | $19,952.62 | $38,904.51 |
United Setting Professional Modifier None Typical Low $6,025.60 Median $6,165.95 Typical High $10,964.78 | Professional | None | $6,025.60 | $6,165.95 | $10,964.78 |
Wellmark Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
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 $2,818.38 Median $4,786.30 Typical High $5,370.32 | Professional | 52 · Reduced service | $2,818.38 | $4,786.30 | $5,370.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,905.46 Typical High $2,137.96 | Professional | 53 · Discontinued | $1,122.02 | $1,905.46 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $831.76 Median $1,445.44 Typical High $1,621.81 | Professional | 55 · Aftercare only | $831.76 | $1,445.44 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $562.34 Median $954.99 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $562.34 | $954.99 | $1,071.52 |
Where Iowa sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$12,303
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.