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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $549.54 | Professional | None | $323.59 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $794.33 Typical High $794.33 | Facility | None | $398.11 | $794.33 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,174.90 | Professional | None | $776.25 | $954.99 | $1,174.90 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $912.01 | Professional | None | $645.65 | $831.76 | $912.01 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $794.33 Typical High $3,630.78 | Facility | None | $478.63 | $794.33 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $676.08 Typical High $1,862.09 | Professional | None | $354.81 | $676.08 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $954.99 | Professional | None | $831.76 | $954.99 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | None | $741.31 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $870.96 Median $1,047.13 Typical High $2,041.74 | Facility | None | $870.96 | $1,047.13 | $2,041.74 |
United Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $630.96 | Professional | None | $338.84 | $354.81 | $630.96 |
Wellmark Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $162.18 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $162.18 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $64.57 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $48.98 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $32.36 | $54.95 | $54.95 |
Where Iowa sits
The same service costs 2.8 times more in Wisconsin 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· 8th of 51
$708
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.