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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $104.71 Typical High $104.71 | Professional | None (both parts) | $79.43 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $208.93 Typical High $223.87 | Professional | None (both parts) | $177.83 | $208.93 | $223.87 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $125.89 Typical High $245.47 | Professional | None | $77.62 | $125.89 | $245.47 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $1,288.25 | Facility | None | $131.83 | $213.80 | $1,288.25 |
Medica Setting Professional Modifier None (both parts) Typical Low $131.83 Median $204.17 Typical High $537.03 | Professional | None (both parts) | $131.83 | $204.17 | $537.03 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | None | $208.93 | $208.93 | $223.87 |
Midlands Setting Professional Modifier None (both parts) Typical Low $218.78 Median $245.47 Typical High $323.59 | Professional | None (both parts) | $218.78 | $245.47 | $323.59 |
United Setting Facility Modifier None Typical Low $562.34 Median $933.25 Typical High $1,174.90 | Facility | None | $562.34 | $933.25 | $1,174.90 |
United Setting Professional Modifier None (both parts) Typical Low $102.33 Median $158.49 Typical High $257.04 | Professional | None (both parts) | $102.33 | $158.49 | $257.04 |
Wellmark Setting Professional Modifier None (both parts) Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | None (both parts) | $141.25 | $141.25 | $165.96 |
6 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 $39.81 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $39.81 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $15.85 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $12.02 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $10.47 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $173.78 Typical High $218.78 | Professional | TC · Technical part | $117.49 | $173.78 | $218.78 |
Medica Setting Professional Modifier TC · Technical part Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | TC · Technical part | $467.74 | $467.74 | $467.74 |
Where Iowa sits
The same service costs 2.9 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· 4th of 51
$166
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.