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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | None | $457.09 | $457.09 | $489.78 |
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 $190.55 Median $190.55 Typical High $588.84 | Professional | None | $190.55 | $190.55 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $489.78 Typical High $1,148.15 | Professional | None | $275.42 | $489.78 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $588.84 Typical High $977.24 | Facility | None | $446.68 | $588.84 | $977.24 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $2,398.83 | Professional | None | $489.78 | $501.19 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $588.84 | Professional | None | $151.36 | $190.55 | $588.84 |
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 $524.81 Median $524.81 Typical High $588.84 | Professional | None | $524.81 | $524.81 | $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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $229.09 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $48.98 |
Where Iowa sits
The same service costs 7.1 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· 16th of 51
$490
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.