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 $33.11 Median $33.11 Typical High $57.54 | Facility | None | $33.11 | $33.11 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $57.54 | Professional | None | $21.88 | $33.11 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $54.95 Typical High $93.33 | Professional | None | $28.18 | $54.95 | $93.33 |
Hally Health Setting Professional Modifier None Typical Low $16.60 Median $28.84 Typical High $67.61 | Professional | None | $16.60 | $28.84 | $67.61 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $77.62 Typical High $104.71 | Facility | None | $56.23 | $77.62 | $104.71 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $67.61 Typical High $147.91 | Professional | None | $39.81 | $67.61 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $79.43 | Professional | None | $46.77 | $77.62 | $79.43 |
Midlands Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $51.29 | Professional | None | $22.39 | $36.31 | $51.29 |
Wellmark Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $72.44 | Professional | None | $34.67 | $40.74 | $72.44 |
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 $10.96 Median $16.60 Typical High $28.18 | Professional | 52 · Reduced service | $10.96 | $16.60 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $6.61 Typical High $11.48 | Professional | 53 · Discontinued | $4.47 | $6.61 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $5.01 Typical High $8.51 | Professional | 55 · Aftercare only | $3.31 | $5.01 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $3.31 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.19 | $3.31 | $5.75 |
Where Iowa sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 3rd of 51
$53.70
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.