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 $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,754.23 | Professional | None | $2,570.40 | $2,570.40 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $269.15 | Facility | None | $190.55 | $239.88 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $190.55 Typical High $190.55 | Professional | None | $95.50 | $190.55 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $2,344.23 Typical High $2,754.23 | Professional | None | $151.36 | $2,344.23 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $416.87 Typical High $1,995.26 | Facility | None | $112.20 | $416.87 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $524.81 Typical High $549.54 | Professional | None | $112.20 | $524.81 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $190.55 | Professional | None | $114.82 | $190.55 | $190.55 |
Midlands Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $302.00 | Facility | None | $190.55 | $239.88 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $257.04 | Professional | None | $114.82 | $141.25 | $257.04 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | None | $125.89 | $125.89 | $134.90 |
Wellmark Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Wellmark Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 $1,288.25 Median $1,288.25 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 53 · Discontinued | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $275.42 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $275.42 |
Where Iowa sits
The same service costs 37.2 times more in Wyoming than in North Carolina. 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· 14th of 51
$427
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.