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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | None | $602.56 | $602.56 | $660.69 |
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 $1,202.26 | Professional | None | $190.55 | $190.55 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $199.53 Median $660.69 Typical High $1,584.89 | Professional | None | $199.53 | $660.69 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $1,318.26 Typical High $2,137.96 | Facility | None | $588.84 | $1,318.26 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $5,754.40 | Professional | None | $724.44 | $758.58 | $5,754.40 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $602.56 | Professional | None | $151.36 | $190.55 | $602.56 |
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 $602.56 Median $602.56 Typical High $1,513.56 | Professional | None | $602.56 | $602.56 | $1,513.56 |
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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $302.00 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $66.07 |
Where Iowa sits
The same service costs 12.6 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· 20th of 51
$661
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.