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 $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,148.15 | $2,041.74 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $2,951.21 | Facility | None | $1,479.11 | $2,951.21 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $3,548.13 Typical High $3,890.45 | Professional | None | $2,754.23 | $3,548.13 | $3,890.45 |
Hally Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $3,630.78 | Professional | None | $2,511.89 | $2,630.27 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $1,778.28 Median $2,884.03 Typical High $11,481.54 | Facility | None | $1,778.28 | $2,884.03 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $6,918.31 | Professional | None | $1,288.25 | $2,238.72 | $6,918.31 |
Midlands Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,019.95 | $3,548.13 | $3,548.13 |
Midlands Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $2,754.23 Median $4,365.16 Typical High $4,365.16 | Professional | None | $2,754.23 | $4,365.16 | $4,365.16 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,318.26 | $2,290.87 |
Wellmark Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $575.44 Median $1,023.29 Typical High $1,148.15 | Professional | 52 · Reduced service | $575.44 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $407.38 Typical High $457.09 | Professional | 53 · Discontinued | $229.09 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $302.00 Typical High $338.84 | Professional | 55 · Aftercare only | $173.78 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $204.17 Typical High $229.09 | Professional | 56 · Pre-op care only | $114.82 | $204.17 | $229.09 |
Where Iowa sits
The same service costs 2.6 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· 4th of 51
$2,630
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.