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 $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $707.95 Typical High $707.95 | Professional | None | $354.81 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,000.00 | Facility | None | $707.95 | $1,000.00 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,202.26 | Professional | None | $912.01 | $1,174.90 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,047.13 | Professional | None | $758.58 | $870.96 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $4,073.80 | Facility | None | $616.60 | $1,000.00 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $2,290.87 | Professional | None | $446.68 | $776.25 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,174.90 | $1,202.26 |
Midlands Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $1,513.56 | Professional | None | $912.01 | $1,513.56 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,511.89 | Facility | None | $1,071.52 | $1,288.25 | $2,511.89 |
United Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $794.33 | Professional | None | $426.58 | $457.09 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $177.83 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $177.83 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $70.79 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $53.70 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $35.48 | $70.79 | $70.79 |
Where Iowa sits
The same service costs 2.0 times more in Iowa 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· 1st of 51
$891
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.