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 $117.49 Median $154.88 Typical High $154.88 | Facility | None | $117.49 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $154.88 | Professional | None | $117.49 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | None | $194.98 | $295.12 | $295.12 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $251.19 | Professional | None | $112.20 | $151.36 | $251.19 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $263.03 Typical High $338.84 | Facility | None | $131.83 | $263.03 | $338.84 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $724.44 | Professional | None | $151.36 | $239.88 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | None | $251.19 | $251.19 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | None | $218.78 | $218.78 | $229.09 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $208.93 | Facility | None | $134.90 | $134.90 | $208.93 |
United Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $346.74 | Professional | None | $128.82 | $199.53 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $181.97 | Professional | None | $151.36 | $151.36 | $181.97 |
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 $58.88 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $58.88 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $23.44 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $17.78 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.75 | $15.49 | $15.49 |
Where Iowa sits
The same service costs 2.8 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· 6th of 51
$191
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.