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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $338.84 | Professional | None | $177.83 | $316.23 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $457.09 Typical High $457.09 | Facility | None | $251.19 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $676.08 | Professional | None | $446.68 | $602.56 | $676.08 |
Hally Health Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $645.65 | Professional | None | $389.05 | $537.03 | $645.65 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $2,089.30 | Facility | None | $275.42 | $446.68 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $1,174.90 | Professional | None | $199.53 | $354.81 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $602.56 | Professional | None | $478.63 | $602.56 | $602.56 |
Midlands Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $676.08 | Professional | None | $467.74 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $354.81 | Professional | None | $199.53 | $204.17 | $354.81 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $87.10 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $87.10 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $35.48 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $46.77 Typical High $51.29 | Professional | 55 · Aftercare only | $26.30 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $17.78 | $31.62 | $33.88 |
Where Iowa sits
The same service costs 3.4 times more in Montana than in New York. 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
$407
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.