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 $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $457.09 | Professional | None | $426.58 | $426.58 | $457.09 |
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 $151.36 Median $190.55 Typical High $512.86 | Professional | None | $151.36 | $190.55 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $794.33 | Professional | None | $275.42 | $457.09 | $794.33 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $676.08 Typical High $1,659.59 | Facility | None | $302.00 | $676.08 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $3,630.78 | Professional | None | $331.13 | $338.84 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $309.03 | Professional | None | $151.36 | $190.55 | $309.03 |
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 $309.03 Median $309.03 Typical High $776.25 | Professional | None | $309.03 | $309.03 | $776.25 |
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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Wellmark Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $213.80 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $213.80 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 53 · Discontinued | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $45.71 |
Where Iowa sits
The same service costs 12.0 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
$363
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.