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 $14.79 Median $14.79 Typical High $28.84 | Facility | None | $14.79 | $14.79 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $14.79 Typical High $28.84 | Professional | None | $9.55 | $14.79 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $31.62 Typical High $52.48 | Professional | None | $19.50 | $31.62 | $52.48 |
Hally Health Setting Professional Modifier None Typical Low $8.13 Median $24.55 Typical High $44.67 | Professional | None | $8.13 | $24.55 | $44.67 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $31.62 Typical High $50.12 | Facility | None | $21.88 | $31.62 | $50.12 |
Medica Setting Professional Modifier None Typical Low $19.05 Median $38.90 Typical High $208.93 | Professional | None | $19.05 | $38.90 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $19.50 Median $39.81 Typical High $47.86 | Professional | None | $19.50 | $39.81 | $47.86 |
Midlands Setting Professional Modifier None Typical Low $17.38 Median $26.92 Typical High $53.70 | Professional | None | $17.38 | $26.92 | $53.70 |
United Setting Professional Modifier None Typical Low $10.23 Median $21.88 Typical High $46.77 | Professional | None | $10.23 | $21.88 | $46.77 |
Wellmark Setting Professional Modifier None Typical Low $15.85 Median $19.05 Typical High $44.67 | Professional | None | $15.85 | $19.05 | $44.67 |
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 $5.37 Median $7.24 Typical High $14.45 | Professional | 52 · Reduced service | $5.37 | $7.24 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.95 Typical High $5.89 | Professional | 53 · Discontinued | $2.14 | $2.95 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $2.19 Typical High $4.37 | Professional | 55 · Aftercare only | $1.58 | $2.19 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.45 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.07 | $1.45 | $2.88 |
Where Iowa sits
The same service costs 3.2 times more in Wisconsin than in Nebraska. 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
$28.84
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.