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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $354.81 Typical High $354.81 | Professional | None | $154.88 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $512.86 | Facility | None | $302.00 | $512.86 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $602.56 | Professional | None | $436.52 | $512.86 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $851.14 | Professional | None | $363.08 | $457.09 | $851.14 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $1,621.81 | Facility | None | $309.03 | $501.19 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $977.24 | Professional | None | $229.09 | $389.05 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | None | $512.86 | $512.86 | $537.03 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $758.58 | Professional | None | $389.05 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $398.11 | Professional | None | $194.98 | $229.09 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $77.62 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $77.62 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $30.90 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $23.44 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $15.49 | $35.48 | $35.48 |
Where Iowa sits
The same service costs 3.0 times more in Iowa 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· 1st of 51
$457
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.