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 $33,884.42 Median $33,884.42 Typical High $33,884.42 | Facility | None | $33,884.42 | $33,884.42 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $16,982.44 Median $33,884.42 Typical High $33,884.42 | Professional | None | $16,982.44 | $33,884.42 | $33,884.42 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $48,977.88 Typical High $48,977.88 | Facility | None | $30,199.52 | $48,977.88 | $48,977.88 |
Cigna Setting Professional Modifier None Typical Low $44,668.36 Median $58,884.37 Typical High $67,608.30 | Professional | None | $44,668.36 | $58,884.37 | $67,608.30 |
Hally Health Setting Professional Modifier None Typical Low $32,359.37 Median $41,686.94 Typical High $46,773.51 | Professional | None | $32,359.37 | $41,686.94 | $46,773.51 |
Medica Setting Facility Modifier None Typical Low $29,512.09 Median $47,863.01 Typical High $204,173.79 | Facility | None | $29,512.09 | $47,863.01 | $204,173.79 |
Medica Setting Professional Modifier None Typical Low $21,877.62 Median $37,153.52 Typical High $114,815.36 | Professional | None | $21,877.62 | $37,153.52 | $114,815.36 |
Midlands Setting Professional Modifier None Typical Low $51,286.14 Median $58,884.37 Typical High $58,884.37 | Professional | None | $51,286.14 | $58,884.37 | $58,884.37 |
Midlands Setting Facility Modifier None Typical Low $48,977.88 Median $48,977.88 Typical High $48,977.88 | Facility | None | $48,977.88 | $48,977.88 | $48,977.88 |
Midlands Setting Professional Modifier None Typical Low $44,668.36 Median $72,443.60 Typical High $72,443.60 | Professional | None | $44,668.36 | $72,443.60 | $72,443.60 |
United Setting Facility Modifier None Typical Low $64,565.42 Median $64,565.42 Typical High $123,026.88 | Facility | None | $64,565.42 | $64,565.42 | $123,026.88 |
United Setting Professional Modifier None Typical Low $20,417.38 Median $21,877.62 Typical High $38,018.94 | Professional | None | $20,417.38 | $21,877.62 | $38,018.94 |
Wellmark Setting Professional Modifier None Typical Low $43,651.58 Median $43,651.58 Typical High $43,651.58 | Professional | None | $43,651.58 | $43,651.58 | $43,651.58 |
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 $8,709.64 Median $16,982.44 Typical High $16,982.44 | Professional | 52 · Reduced service | $8,709.64 | $16,982.44 | $16,982.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,548.13 Median $6,760.83 Typical High $6,760.83 | Professional | 53 · Discontinued | $3,548.13 | $6,760.83 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,630.27 Median $5,128.61 Typical High $5,128.61 | Professional | 55 · Aftercare only | $2,630.27 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,737.80 Median $3,388.44 Typical High $3,388.44 | Professional | 56 · Pre-op care only | $1,737.80 | $3,388.44 | $3,388.44 |
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· 5th of 51
$43,652
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.