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 $83.18 Median $83.18 Typical High $95.50 | Facility | None | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $95.50 | Professional | None | $72.44 | $83.18 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $194.98 | Professional | None | $128.82 | $173.78 | $194.98 |
Hally Health Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $134.90 | Professional | None | $63.10 | $87.10 | $134.90 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $181.97 Typical High $213.80 | Facility | None | $79.43 | $181.97 | $213.80 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $436.52 | Professional | None | $120.23 | $177.83 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $194.98 | Professional | None | $141.25 | $165.96 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $218.78 | Professional | None | $134.90 | $154.88 | $218.78 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $100.00 | Facility | None | $64.57 | $64.57 | $100.00 |
United Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $199.53 | Professional | None | $77.62 | $123.03 | $199.53 |
Wellmark Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $117.49 | Professional | None | $85.11 | $100.00 | $117.49 |
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 $35.48 Median $41.69 Typical High $47.86 | Professional | 52 · Reduced service | $35.48 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.98 Typical High $19.05 | Professional | 53 · Discontinued | $14.45 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.59 Typical High $14.45 | Professional | 55 · Aftercare only | $10.96 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.32 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.08 | $8.32 | $9.55 |
Where Iowa sits
The same service costs 8.1 times more in Alaska than in Indiana. 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
$135
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.