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 $13,489.63 Median $13,489.63 Typical High $13,489.63 | Facility | None | $13,489.63 | $13,489.63 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $7,585.78 Median $13,489.63 Typical High $14,454.40 | Professional | None | $7,585.78 | $13,489.63 | $14,454.40 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $19,498.45 Typical High $19,498.45 | Facility | None | $11,748.98 | $19,498.45 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $17,782.79 Median $25,703.96 Typical High $26,302.68 | Professional | None | $17,782.79 | $25,703.96 | $26,302.68 |
Hally Health Setting Professional Modifier None Typical Low $16,595.87 Median $18,197.01 Typical High $19,952.62 | Professional | None | $16,595.87 | $18,197.01 | $19,952.62 |
Medica Setting Facility Modifier None Typical Low $11,748.98 Median $19,054.61 Typical High $87,096.36 | Facility | None | $11,748.98 | $19,054.61 | $87,096.36 |
Medica Setting Professional Modifier None Typical Low $8,511.38 Median $15,135.61 Typical High $48,977.88 | Professional | None | $8,511.38 | $15,135.61 | $48,977.88 |
Midlands Setting Professional Modifier None Typical Low $19,952.62 Median $25,703.96 Typical High $25,703.96 | Professional | None | $19,952.62 | $25,703.96 | $25,703.96 |
Midlands Setting Facility Modifier None Typical Low $19,498.45 Median $19,498.45 Typical High $19,498.45 | Facility | None | $19,498.45 | $19,498.45 | $19,498.45 |
Midlands Setting Professional Modifier None Typical Low $19,498.45 Median $28,840.32 Typical High $28,840.32 | Professional | None | $19,498.45 | $28,840.32 | $28,840.32 |
United Setting Facility Modifier None Typical Low $8,912.51 Median $27,542.29 Typical High $53,703.18 | Facility | None | $8,912.51 | $27,542.29 | $53,703.18 |
United Setting Professional Modifier None Typical Low $8,511.38 Median $8,709.64 Typical High $15,135.61 | Professional | None | $8,511.38 | $8,709.64 | $15,135.61 |
Wellmark Setting Professional Modifier None Typical Low $17,378.01 Median $17,378.01 Typical High $17,378.01 | Professional | None | $17,378.01 | $17,378.01 | $17,378.01 |
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 $3,715.35 Median $6,760.83 Typical High $7,244.36 | Professional | 52 · Reduced service | $3,715.35 | $6,760.83 | $7,244.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,513.56 Median $2,691.53 Typical High $2,884.03 | Professional | 53 · Discontinued | $1,513.56 | $2,691.53 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,122.02 Median $1,995.26 Typical High $2,187.76 | Professional | 55 · Aftercare only | $1,122.02 | $1,995.26 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $758.58 Median $1,348.96 Typical High $1,445.44 | Professional | 56 · Pre-op care only | $758.58 | $1,348.96 | $1,445.44 |
Where Iowa sits
The same service costs 2.6 times more in Montana 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· 10th of 51
$17,378
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.