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 $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $346.74 | Professional | None | $323.59 | $323.59 | $346.74 |
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 $181.97 Median $190.55 Typical High $489.78 | Professional | None | $181.97 | $190.55 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $758.58 | Professional | None | $275.42 | $346.74 | $758.58 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $812.83 | Facility | None | $426.58 | $549.54 | $812.83 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $2,818.38 | Professional | None | $354.81 | $363.08 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $489.78 | Professional | None | $151.36 | $190.55 | $489.78 |
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 $489.78 Median $489.78 Typical High $588.84 | Professional | None | $489.78 | $489.78 | $588.84 |
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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $162.18 Median $162.18 Typical High $173.78 | Professional | 52 · Reduced service | $162.18 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $64.57 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $52.48 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $34.67 |
Where Iowa sits
The same service costs 5.9 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· 17th of 51
$347
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.