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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $16.60 Typical High $16.60 | Professional | None | $11.22 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $26.30 Typical High $31.62 | Professional | None | $10.72 | $26.30 | $31.62 |
Hally Health Setting Professional Modifier None Typical Low $8.32 Median $10.72 Typical High $36.31 | Professional | None | $8.32 | $10.72 | $36.31 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $30.90 Typical High $151.36 | Facility | None | $25.12 | $30.90 | $151.36 |
Medica Setting Professional Modifier None Typical Low $10.47 Median $25.70 Typical High $281.84 | Professional | None | $10.47 | $25.70 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $26.30 | Professional | None | $22.39 | $22.39 | $26.30 |
Midlands Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
United Setting Facility Modifier None Typical Low $89.13 Median $147.91 Typical High $186.21 | Facility | None | $89.13 | $147.91 | $186.21 |
United Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $18.62 | Professional | None | $9.77 | $11.75 | $18.62 |
Wellmark Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $26.30 | Professional | None | $22.39 | $22.39 | $26.30 |
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 $5.62 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $5.62 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $2.24 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $1.66 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.12 | $1.66 | $1.66 |
Where Iowa sits
The same service costs 3.2 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· 2nd of 51
$22.39
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.