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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $19.50 Typical High $19.50 | Professional | None | $12.88 | $19.50 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $30.90 Typical High $39.81 | Professional | None | $12.30 | $30.90 | $39.81 |
Hally Health Setting Professional Modifier None Typical Low $9.77 Median $12.30 Typical High $288.40 | Professional | None | $9.77 | $12.30 | $288.40 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $38.02 Typical High $323.59 | Facility | None | $31.62 | $38.02 | $323.59 |
Medica Setting Professional Modifier None Typical Low $12.30 Median $30.20 Typical High $1,905.46 | Professional | None | $12.30 | $30.20 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | None | $26.30 | $26.30 | $30.90 |
Midlands Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
United Setting Facility Modifier None Typical Low $56.23 Median $93.33 Typical High $117.49 | Facility | None | $56.23 | $93.33 | $117.49 |
United Setting Professional Modifier None Typical Low $11.22 Median $13.80 Typical High $43.65 | Professional | None | $11.22 | $13.80 | $43.65 |
Wellmark Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | None | $26.30 | $26.30 | $30.90 |
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 $6.46 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $6.46 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $2.57 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $1.95 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.29 | $1.95 | $1.95 |
Where Iowa sits
The same service costs 43.7 times more in Hawaii 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· 7th of 51
$26.30
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.