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 $69.18 Median $69.18 Typical High $102.33 | Facility | None | $69.18 | $69.18 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $102.33 | Professional | None | $44.67 | $69.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $66.07 Typical High $81.28 | Facility | None | $57.54 | $66.07 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $154.88 | Professional | None | $100.00 | $125.89 | $154.88 |
Hally Health Setting Professional Modifier None Typical Low $41.69 Median $89.13 Typical High $141.25 | Professional | None | $41.69 | $89.13 | $141.25 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $151.36 Typical High $1,288.25 | Facility | None | $74.13 | $151.36 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $489.78 | Professional | None | $75.86 | $125.89 | $489.78 |
Midlands Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $147.91 | Professional | None | $85.11 | $125.89 | $147.91 |
Midlands Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $81.28 | Facility | None | $50.12 | $66.07 | $81.28 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $177.83 | Professional | None | $87.10 | $125.89 | $177.83 |
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 $81.28 Typical High $147.91 | Professional | None | $48.98 | $81.28 | $147.91 |
Wellmark Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $165.96 | Professional | None | $81.28 | $95.50 | $165.96 |
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 $34.67 Typical High $51.29 | Professional | 52 · Reduced service | $21.38 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.80 Typical High $20.42 | Professional | 53 · Discontinued | $8.71 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.47 Typical High $15.49 | Professional | 55 · Aftercare only | $6.46 | $10.47 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.92 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.37 | $6.92 | $10.23 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$107
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.