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 $524.81 Median $524.81 Typical High $954.99 | Facility | None | $524.81 | $524.81 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $562.34 | Professional | None | $288.40 | $524.81 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $741.31 Typical High $741.31 | Facility | None | $371.54 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $977.24 | Professional | None | $691.83 | $891.25 | $977.24 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $776.25 | Professional | None | $588.84 | $660.69 | $776.25 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $2,884.03 | Facility | None | $457.09 | $741.31 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $1,737.80 | Professional | None | $331.13 | $575.44 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $891.25 | Professional | None | $776.25 | $891.25 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,122.02 | Professional | None | $691.83 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $588.84 | Professional | None | $316.23 | $338.84 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $144.54 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $144.54 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $57.54 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $43.65 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $28.84 | $52.48 | $56.23 |
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· 10th of 51
$575
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.