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 $14,125.38 Median $14,125.38 Typical High $14,125.38 | Facility | None | $14,125.38 | $14,125.38 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $7,762.47 Median $14,125.38 Typical High $15,135.61 | Professional | None | $7,762.47 | $14,125.38 | $15,135.61 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $20,417.38 Typical High $20,417.38 | Facility | None | $12,589.25 | $20,417.38 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $18,620.87 Median $26,302.68 Typical High $28,183.83 | Professional | None | $18,620.87 | $26,302.68 | $28,183.83 |
Hally Health Setting Professional Modifier None Typical Low $17,378.01 Median $19,498.45 Typical High $21,877.62 | Professional | None | $17,378.01 | $19,498.45 | $21,877.62 |
Medica Setting Facility Modifier None Typical Low $12,302.69 Median $19,952.62 Typical High $91,201.08 | Facility | None | $12,302.69 | $19,952.62 | $91,201.08 |
Medica Setting Professional Modifier None Typical Low $9,120.11 Median $16,218.10 Typical High $51,286.14 | Professional | None | $9,120.11 | $16,218.10 | $51,286.14 |
Midlands Setting Professional Modifier None Typical Low $21,379.62 Median $26,302.68 Typical High $26,302.68 | Professional | None | $21,379.62 | $26,302.68 | $26,302.68 |
Midlands Setting Facility Modifier None Typical Low $20,417.38 Median $20,417.38 Typical High $20,417.38 | Facility | None | $20,417.38 | $20,417.38 | $20,417.38 |
Midlands Setting Professional Modifier None Typical Low $19,952.62 Median $30,199.52 Typical High $30,199.52 | Professional | None | $19,952.62 | $30,199.52 | $30,199.52 |
United Setting Facility Modifier None Typical Low $9,332.54 Median $28,840.32 Typical High $54,954.09 | Facility | None | $9,332.54 | $28,840.32 | $54,954.09 |
United Setting Professional Modifier None Typical Low $8,709.64 Median $9,120.11 Typical High $15,848.93 | Professional | None | $8,709.64 | $9,120.11 | $15,848.93 |
Wellmark Setting Professional Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $18,197.01 | Professional | None | $18,197.01 | $18,197.01 | $18,197.01 |
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 $3,890.45 Median $7,079.46 Typical High $7,585.78 | Professional | 52 · Reduced service | $3,890.45 | $7,079.46 | $7,585.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,548.82 Median $2,818.38 Typical High $3,019.95 | Professional | 53 · Discontinued | $1,548.82 | $2,818.38 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,174.90 Median $2,137.96 Typical High $2,290.87 | Professional | 55 · Aftercare only | $1,174.90 | $2,137.96 | $2,290.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $776.25 Median $1,412.54 Typical High $1,513.56 | Professional | 56 · Pre-op care only | $776.25 | $1,412.54 | $1,513.56 |
Where Iowa sits
The same service costs 2.5 times more in Montana than in Florida. 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
$18,197
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.