How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $125.89 | Professional | None | $61.66 | $93.33 | $125.89 |
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 $151.36 Median $616.60 Typical High $794.33 | Professional | None | $151.36 | $616.60 | $794.33 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $575.44 | Facility | None | $478.63 | $478.63 | $575.44 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,819.70 | Professional | None | $478.63 | $478.63 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $588.84 | Professional | None | $190.55 | $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 $562.34 Median $562.34 Typical High $588.84 | Professional | None | $562.34 | $562.34 | $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 |
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 $30.90 Median $46.77 Typical High $63.10 | Professional | 52 · Reduced service | $30.90 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $18.62 Typical High $25.70 | Professional | 53 · Discontinued | $12.59 | $18.62 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.80 Typical High $19.05 | Professional | 55 · Aftercare only | $9.33 | $13.80 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $9.33 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.17 | $9.33 | $12.59 |
Where Iowa sits
The same service costs 4.1 times more in Alaska 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· 18th of 51
$191
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.