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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | None | $660.69 | $660.69 | $707.95 |
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 $1,230.27 | Professional | None | $151.36 | $190.55 | $1,230.27 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $707.95 Typical High $1,862.09 | Professional | None | $275.42 | $707.95 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $1,659.59 | Facility | None | $1,122.02 | $1,584.89 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $5,623.41 | Professional | None | $933.25 | $977.24 | $5,623.41 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $316.23 | Professional | None | $151.36 | $190.55 | $316.23 |
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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $331.13 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $331.13 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $70.79 |
Where Iowa sits
The same service costs 13.2 times more in Hawaii 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· 19th of 51
$708
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.