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 $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $3,467.37 Typical High $3,715.35 | Professional | None | $1,905.46 | $3,467.37 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $4,897.79 Typical High $4,897.79 | Facility | None | $3,090.30 | $4,897.79 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $4,570.88 Median $5,888.44 Typical High $6,456.54 | Professional | None | $4,570.88 | $5,888.44 | $6,456.54 |
Hally Health Setting Professional Modifier None Typical Low $3,801.89 Median $4,365.16 Typical High $5,011.87 | Professional | None | $3,801.89 | $4,365.16 | $5,011.87 |
Medica Setting Facility Modifier None Typical Low $3,019.95 Median $4,786.30 Typical High $20,892.96 | Facility | None | $3,019.95 | $4,786.30 | $20,892.96 |
Medica Setting Professional Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $11,481.54 | Professional | None | $2,187.76 | $3,801.89 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $5,128.61 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,128.61 | $5,888.44 | $5,888.44 |
Midlands Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $4,570.88 Median $7,413.10 Typical High $7,413.10 | Professional | None | $4,570.88 | $7,413.10 | $7,413.10 |
United Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $12,302.69 | Facility | None | $6,456.54 | $6,456.54 | $12,302.69 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $3,890.45 | Professional | None | $2,041.74 | $2,187.76 | $3,890.45 |
Wellmark Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
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 $954.99 Median $1,698.24 Typical High $1,862.09 | Professional | 52 · Reduced service | $954.99 | $1,698.24 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $691.83 Typical High $741.31 | Professional | 53 · Discontinued | $389.05 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $512.86 Typical High $562.34 | Professional | 55 · Aftercare only | $288.40 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $346.74 Typical High $371.54 | Professional | 56 · Pre-op care only | $190.55 | $346.74 | $371.54 |
Where Iowa sits
The same service costs 2.0 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· 5th of 51
$4,365
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.