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 $67.61 Median $67.61 Typical High $138.04 | Facility | None | $67.61 | $67.61 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $138.04 | Professional | None | $42.66 | $72.44 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $151.36 | Facility | None | $79.43 | $114.82 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $213.80 | Professional | None | $100.00 | $141.25 | $213.80 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $117.49 Typical High $154.88 | Professional | None | $40.74 | $117.49 | $154.88 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $1,288.25 | Facility | None | $100.00 | $194.98 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $645.65 | Professional | None | $93.33 | $162.18 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $85.11 Median $173.78 Typical High $204.17 | Professional | None | $85.11 | $173.78 | $204.17 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $151.36 | Facility | None | $79.43 | $114.82 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $83.18 Median $165.96 Typical High $239.88 | Professional | None | $83.18 | $165.96 | $239.88 |
United Setting Facility Modifier None Typical Low $213.80 Median $575.44 Typical High $1,995.26 | Facility | None | $213.80 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $48.98 Median $93.33 Typical High $194.98 | Professional | None | $48.98 | $93.33 | $194.98 |
Wellmark Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $239.88 | Professional | None | $81.28 | $95.50 | $239.88 |
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 $21.38 Median $36.31 Typical High $69.18 | Professional | 52 · Reduced service | $21.38 | $36.31 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $14.45 Typical High $28.18 | Professional | 53 · Discontinued | $8.51 | $14.45 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.96 Typical High $20.89 | Professional | 55 · Aftercare only | $6.31 | $10.96 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.24 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.27 | $7.24 | $13.80 |
Where Iowa sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 5th of 51
$123
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.