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 $29.51 Typical High $57.54 | Facility | None | $14.79 | $29.51 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $18.20 Typical High $39.81 | Professional | None | $8.91 | $18.20 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $32.36 Typical High $53.70 | Professional | None | $19.95 | $32.36 | $53.70 |
Hally Health Setting Professional Modifier None Typical Low $8.32 Median $25.12 Typical High $37.15 | Professional | None | $8.32 | $25.12 | $37.15 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $33.11 Typical High $45.71 | Facility | None | $22.39 | $33.11 | $45.71 |
Medica Setting Professional Modifier None Typical Low $19.50 Median $38.90 Typical High $72.44 | Professional | None | $19.50 | $38.90 | $72.44 |
Midlands Setting Professional Modifier None Typical Low $19.95 Median $40.74 Typical High $45.71 | Professional | None | $19.95 | $40.74 | $45.71 |
Midlands Setting Professional Modifier None Typical Low $18.20 Median $28.18 Typical High $53.70 | Professional | None | $18.20 | $28.18 | $53.70 |
United Setting Professional Modifier None Typical Low $10.96 Median $23.44 Typical High $47.86 | Professional | None | $10.96 | $23.44 | $47.86 |
Wellmark Setting Professional Modifier None Typical Low $16.60 Median $19.50 Typical High $46.77 | Professional | None | $16.60 | $19.50 | $46.77 |
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 $5.50 Median $7.41 Typical High $14.79 | Professional | 52 · Reduced service | $5.50 | $7.41 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.95 Typical High $5.89 | Professional | 53 · Discontinued | $2.19 | $2.95 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.24 Typical High $4.37 | Professional | 55 · Aftercare only | $1.66 | $2.24 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.48 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.12 | $1.48 | $2.95 |
Where Iowa sits
The same service costs 3.1 times more in Wisconsin than in Louisiana. 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· 4th of 51
$28.18
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.