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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | None | $512.86 | $512.86 | $549.54 |
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 $1,348.96 | Professional | None | $181.97 | $190.55 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $549.54 Typical High $758.58 | Professional | None | $275.42 | $549.54 | $758.58 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $1,258.93 Typical High $1,513.56 | Facility | None | $234.42 | $1,258.93 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $4,786.30 | Professional | None | $194.98 | $208.93 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $1,548.82 | Professional | None | $151.36 | $190.55 | $1,548.82 |
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 $380.19 Median $380.19 Typical High $1,548.82 | Professional | None | $380.19 | $380.19 | $1,548.82 |
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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $257.04 Median $257.04 Typical High $275.42 | Professional | 52 · Reduced service | $257.04 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 53 · Discontinued | $102.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $54.95 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $54.95 |
Where Iowa sits
The same service costs 9.1 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· 17th of 51
$295
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.