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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | None | $416.87 | $416.87 | $446.68 |
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 $1,584.89 | Professional | None | $190.55 | $190.55 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $1,380.38 | Professional | None | $275.42 | $446.68 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $1,548.82 | Facility | None | $575.44 | $1,380.38 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $2,691.53 | Professional | None | $478.63 | $501.19 | $2,691.53 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $1,584.89 | Professional | None | $151.36 | $190.55 | $1,584.89 |
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 $912.01 Median $912.01 Typical High $1,584.89 | Professional | None | $912.01 | $912.01 | $1,584.89 |
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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Wellmark Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $208.93 Median $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $44.67 |
Where Iowa sits
The same service costs 10.0 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· 20th of 51
$447
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.