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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | None | $85.11 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $208.93 Typical High $229.09 | Professional | None | $100.00 | $208.93 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $257.04 | Professional | None | $81.28 | $151.36 | $257.04 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $257.04 | Facility | None | $165.96 | $199.53 | $257.04 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $933.25 | Professional | None | $114.82 | $204.17 | $933.25 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $239.88 | Professional | None | $177.83 | $208.93 | $239.88 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $239.88 | Professional | None | $169.82 | $194.98 | $239.88 |
United Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $245.47 | Professional | None | $97.72 | $141.25 | $245.47 |
Wellmark Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | None | $134.90 | $134.90 | $158.49 |
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 $42.66 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $42.66 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $16.98 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.51 | $10.72 | $10.72 |
Where Iowa sits
The same service costs 3.1 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· 6th of 51
$158
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.